Provider Demographics
NPI:1093054439
Name:ATLAS PEDIATRIC THERAPY CONSULTANTS LLC
Entity Type:Organization
Organization Name:ATLAS PEDIATRIC THERAPY CONSULTANTS LLC
Other - Org Name:ATLAS PEDIATRIC THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-203-2622
Mailing Address - Street 1:2015 E LAMAR BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76006-7349
Mailing Address - Country:US
Mailing Address - Phone:817-203-2622
Mailing Address - Fax:817-704-4334
Practice Address - Street 1:2015 E LAMAR BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76006-7349
Practice Address - Country:US
Practice Address - Phone:817-203-2622
Practice Address - Fax:817-704-4334
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-05
Last Update Date:2013-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX316695101Medicaid