Provider Demographics
NPI:1639873557
Name:ACCESS CONCIERGE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ACCESS CONCIERGE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:PREMILA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:281-969-8922
Mailing Address - Street 1:5926 METAPHOR WAY
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2050
Mailing Address - Country:US
Mailing Address - Phone:630-730-8922
Mailing Address - Fax:281-969-8941
Practice Address - Street 1:5926 METAPHOR WAY
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77469-2050
Practice Address - Country:US
Practice Address - Phone:630-730-0891
Practice Address - Fax:281-969-8941
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-27
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty