Provider Demographics
NPI:1235355066
Name:GLOBAL FUNCTIONAL TESTING CORPORATION
Entity Type:Organization
Organization Name:GLOBAL FUNCTIONAL TESTING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ENRIQUE
Authorized Official - Middle Name:
Authorized Official - Last Name:COLON
Authorized Official - Suffix:
Authorized Official - Credentials:LICENSE THERAPIST
Authorized Official - Phone:281-478-4336
Mailing Address - Street 1:3705 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:TX
Mailing Address - Zip Code:77536-6493
Mailing Address - Country:US
Mailing Address - Phone:281-478-4336
Mailing Address - Fax:281-478-4336
Practice Address - Street 1:3705 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:DEER PARK
Practice Address - State:TX
Practice Address - Zip Code:77536-6493
Practice Address - Country:US
Practice Address - Phone:281-478-4336
Practice Address - Fax:281-478-4336
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1145043225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX01121970OtherDOB
TX$$$$$$$$$OtherSOCIAL SECURITY