Provider Demographics
NPI:1750374187
Name:AFTER HOURS THERAPY PC
Entity type:Organization
Organization Name:AFTER HOURS THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JACKIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-596-8999
Mailing Address - Street 1:3325 CHANDLER HWY
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75702-7648
Mailing Address - Country:US
Mailing Address - Phone:903-596-8999
Mailing Address - Fax:903-531-2248
Practice Address - Street 1:3325 CHANDLER HWY
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75702-7648
Practice Address - Country:US
Practice Address - Phone:903-531-2243
Practice Address - Fax:903-531-2248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy