Provider Demographics
NPI: | 1689995052 |
---|---|
Name: | RMG PHYSICAL THERAPY |
Entity Type: | Organization |
Organization Name: | RMG PHYSICAL THERAPY |
Other - Org Name: | BODYWISE PHYSICAL THERAPY AND PILATES REHAB |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | RUPAL |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | PATEL |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | DPT |
Authorized Official - Phone: | 512-297-2860 |
Mailing Address - Street 1: | 1305 E 6TH ST APT 4 |
Mailing Address - Street 2: | |
Mailing Address - City: | AUSTIN |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78702-3374 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 1305 E 6TH ST APT 4 |
Practice Address - Street 2: | |
Practice Address - City: | AUSTIN |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78702-3374 |
Practice Address - Country: | US |
Practice Address - Phone: | 512-297-2860 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2010-06-19 |
Last Update Date: | 2013-12-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 668500000 | 261QP2000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |