Provider Demographics
NPI:1467212977
Name:ATHLETX PERFORMANCE & REHAB LLC
Entity Type:Organization
Organization Name:ATHLETX PERFORMANCE & REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MALIK
Authorized Official - Middle Name:
Authorized Official - Last Name:OKKEHJ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-230-3015
Mailing Address - Street 1:9320 DALLAS PKWY STE 190
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4206
Mailing Address - Country:US
Mailing Address - Phone:469-230-3015
Mailing Address - Fax:
Practice Address - Street 1:9320 DALLAS PKWY STE 190
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4206
Practice Address - Country:US
Practice Address - Phone:469-230-3015
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-21
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty