Provider Demographics
NPI:1760992465
Name:TEXAS UNITED REHAB THERAPY SPECIALISTS LLC
Entity Type:Organization
Organization Name:TEXAS UNITED REHAB THERAPY SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:OLADIPUPO
Authorized Official - Middle Name:A
Authorized Official - Last Name:MUSTAPHA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:210-236-0911
Mailing Address - Street 1:20079 STONE OAK PKWY STE 1230
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-6957
Mailing Address - Country:US
Mailing Address - Phone:210-236-0911
Mailing Address - Fax:210-899-0912
Practice Address - Street 1:20079 STONE OAK PKWY STE 1230
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-6957
Practice Address - Country:US
Practice Address - Phone:210-236-0911
Practice Address - Fax:210-899-0912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-07
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1248635225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty