Provider Demographics
NPI:1508411299
Name:SURGE MOBILE PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:SURGE MOBILE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROCIO
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:210-815-4383
Mailing Address - Street 1:7135 FRONTAGE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:OLMITO
Mailing Address - State:TX
Mailing Address - Zip Code:78575
Mailing Address - Country:US
Mailing Address - Phone:956-413-7799
Mailing Address - Fax:956-815-2019
Practice Address - Street 1:7135 FRONTAGE RD
Practice Address - Street 2:SUITE B
Practice Address - City:OLMITO
Practice Address - State:TX
Practice Address - Zip Code:78575
Practice Address - Country:US
Practice Address - Phone:956-413-7799
Practice Address - Fax:956-815-2019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-08
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty