Provider Demographics
NPI:1720546195
Name:3D PT ORTHOPEDIC REHAB
Entity Type:Organization
Organization Name:3D PT ORTHOPEDIC REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGELIO
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:PULIDO
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:479-220-9894
Mailing Address - Street 1:1768 MARQUETTE AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-8125
Mailing Address - Country:US
Mailing Address - Phone:479-220-9894
Mailing Address - Fax:
Practice Address - Street 1:2200 BOCA CHICA BLVD STE 130
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2217
Practice Address - Country:US
Practice Address - Phone:956-641-1087
Practice Address - Fax:956-404-0808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty