Provider Demographics
NPI:1790847267
Name:JOSEPH J TEIXEIRA RPT PC
Entity Type:Organization
Organization Name:JOSEPH J TEIXEIRA RPT PC
Other - Org Name:PERFORMAX PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:J
Authorized Official - Last Name:TEIXEIRA
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:303-932-2500
Mailing Address - Street 1:5920 S ESTES ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-8618
Mailing Address - Country:US
Mailing Address - Phone:303-932-2500
Mailing Address - Fax:303-932-2600
Practice Address - Street 1:5920 S ESTES ST
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-8618
Practice Address - Country:US
Practice Address - Phone:303-932-2500
Practice Address - Fax:303-932-2600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC465848225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC465848Medicare PIN