Provider Demographics
NPI:1336324953
Name:BBC REHAB & DIAGNOSTICS
Entity Type:Organization
Organization Name:BBC REHAB & DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANA
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:LACKEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-270-4800
Mailing Address - Street 1:1151 N BUCKNER BLVD
Mailing Address - Street 2:SUITE 305
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75218-3426
Mailing Address - Country:US
Mailing Address - Phone:972-270-4800
Mailing Address - Fax:214-367-1153
Practice Address - Street 1:1151 N BUCKNER BLVD
Practice Address - Street 2:SUITE 305
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75218-3426
Practice Address - Country:US
Practice Address - Phone:972-270-4800
Practice Address - Fax:214-367-1153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy