Provider Demographics
NPI:1518298819
Name:ENERGY REHAB SERVICES
Entity Type:Organization
Organization Name:ENERGY REHAB SERVICES
Other - Org Name:HIGH FIVE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / AUTHORIZED OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:HELGA
Authorized Official - Middle Name:D
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CFC
Authorized Official - Phone:972-546-0411
Mailing Address - Street 1:12222 MERIT DR STE 320
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-3221
Mailing Address - Country:US
Mailing Address - Phone:972-546-0411
Mailing Address - Fax:972-559-1867
Practice Address - Street 1:12222 MERIT DR STE 320
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-3221
Practice Address - Country:US
Practice Address - Phone:972-546-0411
Practice Address - Fax:972-559-1867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-26
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX668150000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0006YFOtherBCBSTX
TXTXB103415Medicare PIN