Provider Demographics
NPI:1679719637
Name:TOWN EAST PHYSICAL THERAPY & REHABILIATION
Entity Type:Organization
Organization Name:TOWN EAST PHYSICAL THERAPY & REHABILIATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:A
Authorized Official - Last Name:WINBURNE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:972-270-2277
Mailing Address - Street 1:18601 LYNDON B JOHNSON FWY STE 116
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-5629
Mailing Address - Country:US
Mailing Address - Phone:972-270-2277
Mailing Address - Fax:972-270-2277
Practice Address - Street 1:18601 LYNDON B JOHNSON FWY STE 116
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-5629
Practice Address - Country:US
Practice Address - Phone:972-270-2277
Practice Address - Fax:972-270-2277
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66382000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy