Provider Demographics
NPI:1326198292
Name:PAULA ELROD, PT, PC
Entity Type:Organization
Organization Name:PAULA ELROD, PT, PC
Other - Org Name:ELROD PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:
Authorized Official - Last Name:ELROD
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:432-550-8777
Mailing Address - Street 1:1514 N GRANDVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-3029
Mailing Address - Country:US
Mailing Address - Phone:432-550-8777
Mailing Address - Fax:432-550-8333
Practice Address - Street 1:1514 N GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-3029
Practice Address - Country:US
Practice Address - Phone:432-550-8777
Practice Address - Fax:432-550-8333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1063055225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX456835Medicare ID - Type UnspecifiedORF