Provider Demographics
NPI:1093440513
Name:COMPLETE PERFORMANCE PHYSICAL THERAPY, PLLC
Entity Type:Organization
Organization Name:COMPLETE PERFORMANCE PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPT
Authorized Official - Prefix:
Authorized Official - First Name:MAYRA
Authorized Official - Middle Name:CAROLINA
Authorized Official - Last Name:NAVARRETE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:915-329-6659
Mailing Address - Street 1:780 N RESLER DR STE B
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-7196
Mailing Address - Country:US
Mailing Address - Phone:915-626-5358
Mailing Address - Fax:915-581-3862
Practice Address - Street 1:780 N RESLER DR STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-7196
Practice Address - Country:US
Practice Address - Phone:915-626-5358
Practice Address - Fax:915-581-3862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty