Organization Name: | PHYTEX REHABILITATION, LLC |
NPI Number: | 1053405977 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JAMES C CARLSON (ADMINISTRATOR) |
Mailing Address: | 2525 N Grandview Ave Suite 400 Odessa |
State: | TX US |
Postal Code: | 797611600 |
Phone Number: | 4325504700 |
Fax Number: | 4325504715 |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 02/29/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |