Organization Name: | APEX PHYSICAL MEDICINE, PA |
NPI Number: | 1639576366 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JADE MALAY (DIRECTOR) |
Mailing Address: | 8700 Us Highway 380 Ste 200 Crossroads |
State: | TX US |
Postal Code: | 762272660 |
Phone Number: | 9403659400 |
Fax Number: | 9403659106 |
NPI Enumeration Date: | 11/24/2014 |
NPI Last Update Date: | 11/24/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | BA0534328 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |