Provider Demographics
NPI:1225475635
Name:TEXAS PHYSICAL THERAPY SPECIALISTS
Entity Type:Organization
Organization Name:TEXAS PHYSICAL THERAPY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SHYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:BURRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-590-4002
Mailing Address - Street 1:204 S INTERSTATE 35
Mailing Address - Street 2:SUITE 203
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-4126
Mailing Address - Country:US
Mailing Address - Phone:512-863-7761
Mailing Address - Fax:512-863-0973
Practice Address - Street 1:10526 W PARMER LN BLDG 4
Practice Address - Street 2:SUITE 403
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78717-4873
Practice Address - Country:US
Practice Address - Phone:512-900-3302
Practice Address - Fax:512-372-3943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-24
Last Update Date:2016-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX620940006225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty