Provider Demographics
NPI:1093121824
Name:WARD THERAPIES, PC
Entity Type:Organization
Organization Name:WARD THERAPIES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:TIMOTHY
Authorized Official - Last Name:WARD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:979-739-3940
Mailing Address - Street 1:1302 DEACON DR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-6405
Mailing Address - Country:US
Mailing Address - Phone:979-739-3940
Mailing Address - Fax:
Practice Address - Street 1:1302 DEACON DR
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-6405
Practice Address - Country:US
Practice Address - Phone:979-739-3940
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-01
Last Update Date:2015-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1130268261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1093121824OtherNPI
TX1386704187OtherPROVIDER'S NPI
TX365115OtherMEDICARE PROVIDER#
TX87T45OtherBCBS
TX86496TOtherBCBS
TX1386704187Medicaid
TX1386704187Medicaid