Provider Demographics
NPI:1497878383
Name:AMIGOS THERAPY SERVICES, PLLC
Entity Type:Organization
Organization Name:AMIGOS THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:RUBEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEIRA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:214-727-6225
Mailing Address - Street 1:4212 LAVACA DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-3501
Mailing Address - Country:US
Mailing Address - Phone:469-366-4877
Mailing Address - Fax:972-509-8937
Practice Address - Street 1:3305 DILIDO RD
Practice Address - Street 2:SUITE 134
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-8337
Practice Address - Country:US
Practice Address - Phone:214-727-6225
Practice Address - Fax:972-509-8937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1081669261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy