Provider Demographics
NPI:1902183643
Name:GATEWAY PARTNERS INC
Entity Type:Organization
Organization Name:GATEWAY PARTNERS INC
Other - Org Name:GATEWAY PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-431-8700
Mailing Address - Street 1:8857 DAVIS BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76248-0308
Mailing Address - Country:US
Mailing Address - Phone:817-431-8700
Mailing Address - Fax:817-431-8811
Practice Address - Street 1:8857 DAVIS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76248-0308
Practice Address - Country:US
Practice Address - Phone:817-431-8700
Practice Address - Fax:817-431-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-09
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX671580000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0098WZOtherBCBS TX
TX3073934-01Medicaid
TXTXB157249Medicare PIN