Provider Demographics
NPI:1114257748
Name:HCW ELITE PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:HCW ELITE PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PT
Authorized Official - Prefix:
Authorized Official - First Name:NAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-328-6876
Mailing Address - Street 1:1711 HERITAGE PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75092-7163
Mailing Address - Country:US
Mailing Address - Phone:903-328-6876
Mailing Address - Fax:903-870-1425
Practice Address - Street 1:1711 HERITAGE PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-7163
Practice Address - Country:US
Practice Address - Phone:903-328-6876
Practice Address - Fax:903-870-1425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10553902251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX270886907OtherOUTPATIENT PHYSICAL THERAPY CLINIC
TX=========OtherOUTPATIENT PHYSICAL THERAPY