Provider Demographics
NPI:1801516471
Name:PHYSIOBACKPT LLC
Entity type:Organization
Organization Name:PHYSIOBACKPT LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDELHADI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:469-573-3469
Mailing Address - Street 1:5345 N GARLAND AVE STE 370
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75040-2799
Mailing Address - Country:US
Mailing Address - Phone:469-573-3469
Mailing Address - Fax:469-573-3469
Practice Address - Street 1:5435 N GARLAND AVE STE 370
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-2785
Practice Address - Country:US
Practice Address - Phone:469-573-3469
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-01
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy