Provider Demographics
NPI:1295816965
Name:SPORTCARE REHABILITATION INC
Entity Type:Organization
Organization Name:SPORTCARE REHABILITATION INC
Other - Org Name:SPORTCARE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:CURNYN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:817-923-9000
Mailing Address - Street 1:4750 BRYANT IRVIN RD N
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-7641
Mailing Address - Country:US
Mailing Address - Phone:817-923-9000
Mailing Address - Fax:817-923-9033
Practice Address - Street 1:4750 BRYANT IRVIN RD N
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-7641
Practice Address - Country:US
Practice Address - Phone:817-923-9000
Practice Address - Fax:817-923-9033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX80350TOtherBCBS PROVIDER NUMBER
TX80350TOtherBCBS PROVIDER NUMBER