Provider Demographics
NPI:1619000734
Name:PHYSICAL THERAPY CARE
Entity Type:Organization
Organization Name:PHYSICAL THERAPY CARE
Other - Org Name:PHYSICAL THERAPY CARE FT. BEND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:E
Authorized Official - Last Name:KOCICH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:281-344-8900
Mailing Address - Street 1:20707 CHADBURY PARK DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-6638
Mailing Address - Country:US
Mailing Address - Phone:281-344-8900
Mailing Address - Fax:281-344-8926
Practice Address - Street 1:20707 CHADBURY PARK DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6638
Practice Address - Country:US
Practice Address - Phone:281-344-8900
Practice Address - Fax:281-344-8926
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056018225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G0149Medicare ID - Type Unspecified