Provider Demographics
NPI:1861847329
Name:FREEDOM PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:FREEDOM PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:ANGELI
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:956-689-5301
Mailing Address - Street 1:PO BOX 92
Mailing Address - Street 2:
Mailing Address - City:RAYMONDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78580-0092
Mailing Address - Country:US
Mailing Address - Phone:956-689-5301
Mailing Address - Fax:956-689-2004
Practice Address - Street 1:100 N US HIGHWAY 77
Practice Address - Street 2:SUITE I
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-4000
Practice Address - Country:US
Practice Address - Phone:956-699-3022
Practice Address - Fax:956-689-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-03
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1085371261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy