Provider Demographics
NPI:1245210152
Name:AFFILIATED PHYSICAL THERAPY AND REHABILITATION CLINIC, INC.
Entity Type:Organization
Organization Name:AFFILIATED PHYSICAL THERAPY AND REHABILITATION CLINIC, INC.
Other - Org Name:AFFILIATED THERAPIES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:BILLINGS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:512-443-2400
Mailing Address - Street 1:4310 JAMES CASEY ST
Mailing Address - Street 2:SUITE 1D
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-1120
Mailing Address - Country:US
Mailing Address - Phone:512-445-5213
Mailing Address - Fax:512-445-4353
Practice Address - Street 1:15803 WINDERMERE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-2402
Practice Address - Country:US
Practice Address - Phone:512-670-2017
Practice Address - Fax:512-670-2038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2251X0800X, 225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Not Answered225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXGROUP 00542EMedicare ID - Type Unspecified1/4 LOCATIONS (2GRP#'S)