Provider Demographics
NPI:1336911684
Name:RUNDOC
Entity Type:Organization
Organization Name:RUNDOC
Other - Org Name:PERSISTENT THERAPY & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:POLLAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-926-9323
Mailing Address - Street 1:305 BAYONET DR
Mailing Address - Street 2:
Mailing Address - City:WHITE SETTLEMENT
Mailing Address - State:TX
Mailing Address - Zip Code:76108-4782
Mailing Address - Country:US
Mailing Address - Phone:214-926-9323
Mailing Address - Fax:
Practice Address - Street 1:305 BAYONET DR
Practice Address - Street 2:
Practice Address - City:WHITE SETTLEMENT
Practice Address - State:TX
Practice Address - Zip Code:76108-4782
Practice Address - Country:US
Practice Address - Phone:214-926-9323
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-30
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty