Provider Demographics
NPI:1376804351
Name:BEYOND THERAPY AND WELLNESS PLLC
Entity Type:Organization
Organization Name:BEYOND THERAPY AND WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:LATHAM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:817-786-8058
Mailing Address - Street 1:1248 HARWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4244
Mailing Address - Country:US
Mailing Address - Phone:817-786-8058
Mailing Address - Fax:817-786-8057
Practice Address - Street 1:1248 HARWOOD RD
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4244
Practice Address - Country:US
Practice Address - Phone:817-786-8058
Practice Address - Fax:817-786-8057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty