Provider Demographics
NPI:1245471333
Name:TEXAS PHYSICAL MEDICINE AND REHABILITATIN INSTITUTE INC
Entity type:Organization
Organization Name:TEXAS PHYSICAL MEDICINE AND REHABILITATIN INSTITUTE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:U
Authorized Official - Last Name:OSONDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-403-3813
Mailing Address - Street 1:PO BOX 1371
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76095-1371
Mailing Address - Country:US
Mailing Address - Phone:214-403-3813
Mailing Address - Fax:940-321-0173
Practice Address - Street 1:1600 CENTRAL DR
Practice Address - Street 2:SUITE # 156
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6000
Practice Address - Country:US
Practice Address - Phone:214-403-3813
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1009090261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherEIN