Provider Demographics
NPI:1619905213
Name:PHYSICAL RESOURCES, LLC
Entity Type:Organization
Organization Name:PHYSICAL RESOURCES, LLC
Other - Org Name:BODYWORKS PHYSICAL THERAPY & SPORTMED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MUNDHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:817-485-2300
Mailing Address - Street 1:PO BOX 2067
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-2067
Mailing Address - Country:US
Mailing Address - Phone:817-485-2300
Mailing Address - Fax:
Practice Address - Street 1:2318 50TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-2502
Practice Address - Country:US
Practice Address - Phone:806-748-6407
Practice Address - Fax:806-687-2806
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy