Provider Demographics
NPI:1679460174
Name:PRIME PERFORMANCE PT LLC
Entity type:Organization
Organization Name:PRIME PERFORMANCE PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT,
Authorized Official - Phone:915-691-0427
Mailing Address - Street 1:7737 OAK LANDING DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-1336
Mailing Address - Country:US
Mailing Address - Phone:915-691-0427
Mailing Address - Fax:
Practice Address - Street 1:3400 KASHIWA ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4025
Practice Address - Country:US
Practice Address - Phone:915-691-0427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy