Provider Demographics
NPI:1235363979
Name:DUMAS PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:DUMAS PHYSICAL THERAPY, LLC
Other - Org Name:DUMAS PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC ADMIN DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:GODFREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:402-334-6025
Mailing Address - Street 1:11623 ARBOR ST STE 200
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68144-2991
Mailing Address - Country:US
Mailing Address - Phone:402-334-6025
Mailing Address - Fax:402-334-6081
Practice Address - Street 1:515 E 1ST ST
Practice Address - Street 2:
Practice Address - City:DUMAS
Practice Address - State:TX
Practice Address - Zip Code:79029-3219
Practice Address - Country:US
Practice Address - Phone:806-934-2634
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-10
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1013613OtherSTATE LICENSURE
TX204772201Medicaid