MEDICARE: SEVA REHAB LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2R8599	OTHER	TX	MEDICARE PTAN

General Provider Information

NPI Number	:	1235842857
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SEVA REHAB LLC

Provider Business Mailing Address
First Line	:	11655 INDEPENDENCE PKWY STE 240
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-4719
Country	:	US
Telephone Number	:	469-647-4833
Fax Number	:	469-647-5179

Provider Business Practice Location Address
First Line	:	11655 INDEPENDENCE PKWY STE 240
Second Line	:
City	:	FRISCO
State	:	TX
Zip	:	75035-4719
Country	:	US
Telephone Number	:	469-647-4833
Fax Number	:	469-647-5179

Authorized Official
Title or Position	:	PRACTICE OWNER
Name	:	RUSHI SHAHIWALA
Credential	:
Telephone Number	:	201-744-5549

Provider Enumeration Date	:	12/28/2022
Last Update Date	:	07/20/2023

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Directions to “SEVA REHAB LLC ” Practice Location

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