Provider Demographics
NPI:1841232485
Name:TEXAS ORTHOPAEDIC THERAPY SPECIALIST PC
Entity Type:Organization
Organization Name:TEXAS ORTHOPAEDIC THERAPY SPECIALIST PC
Other - Org Name:TEXAS OTHOPAEDIC THERAPY SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DUNCAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MCDONALD
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:915-633-8600
Mailing Address - Street 1:11450 ROJAS DR.
Mailing Address - Street 2:SUITE D-1
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6993
Mailing Address - Country:US
Mailing Address - Phone:915-633-8600
Mailing Address - Fax:915-633-8700
Practice Address - Street 1:11450 ROJAS DR.
Practice Address - Street 2:SUITE D-1
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-6993
Practice Address - Country:US
Practice Address - Phone:915-633-8600
Practice Address - Fax:915-633-8700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2020-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00702VMedicaid
TX163264801Medicaid