Provider Demographics
NPI:1851567374
Name:FORT WORTH REHAB GROUP, INC.
Entity Type:Organization
Organization Name:FORT WORTH REHAB GROUP, INC.
Other - Org Name:AMERICARE CLINICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:E
Authorized Official - Last Name:SONES
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-263-3055
Mailing Address - Street 1:928 N BELT LINE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-5864
Mailing Address - Country:US
Mailing Address - Phone:972-263-3055
Mailing Address - Fax:972-266-5286
Practice Address - Street 1:928 N BELT LINE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75050-5864
Practice Address - Country:US
Practice Address - Phone:972-263-3055
Practice Address - Fax:972-266-5286
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2737111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty