Provider Demographics
NPI:1154500312
Name:TBSI THERAPIES, LLC
Entity Type:Organization
Organization Name:TBSI THERAPIES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-776-8896
Mailing Address - Street 1:3201 UNIVERSITY DR E STE 415
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802-3479
Mailing Address - Country:US
Mailing Address - Phone:979-776-8896
Mailing Address - Fax:
Practice Address - Street 1:3201 UNIVERSITY DR E STE 415
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3479
Practice Address - Country:US
Practice Address - Phone:979-776-8896
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0048QKOtherBLUE CROSS BLUE SHIELD
TX00Y584Medicare PIN