Organization Name: | THOMAS L REID PTPC |
NPI Number: | 1588978068 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | THOMAS L REID (OWNER) |
Mailing Address: | 408 Central Dr Azle |
State: | TX US |
Postal Code: | 760203140 |
Phone Number: | 8174448827 |
Fax Number: | 8174448847 |
NPI Enumeration Date: | 07/27/2010 |
NPI Last Update Date: | 07/27/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2000X |
License Number: | 603330000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Physical Therapy |
Taxonomy Definition: |