Provider Demographics
NPI:1225759392
Name:X FACTOR REHAB CORP
Entity Type:Organization
Organization Name:X FACTOR REHAB CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SIERRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-479-7263
Mailing Address - Street 1:1717 PRECINCT LINE RD STE 204
Mailing Address - Street 2:
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-3169
Mailing Address - Country:US
Mailing Address - Phone:817-479-7263
Mailing Address - Fax:817-479-3954
Practice Address - Street 1:1717 PRECINCT LINE RD STE 204
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3169
Practice Address - Country:US
Practice Address - Phone:817-479-7263
Practice Address - Fax:817-479-3954
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy