MEDICARE: SUMMIT REHAB

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		TX

General Provider Information

NPI Number	:	1366654295
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUMMIT REHAB

Provider Business Mailing Address
First Line	:	2420 E RANDOL MILL RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-6335
Country	:	US
Telephone Number	:	817-394-1010
Fax Number	:	817-394-1017

Provider Business Practice Location Address
First Line	:	2420 E RANDOL MILL RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-6335
Country	:	US
Telephone Number	:	817-394-1010
Fax Number	:	817-394-1017

Authorized Official
Title or Position	:	DIRECTOR
Name	:	STELLA HANNAH
Credential	:
Telephone Number	:	817-394-1010

Provider Enumeration Date	:	05/04/2007
Last Update Date	:	08/22/2020

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Practice Location Address:

2420 E RANDOL MILL RD
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Practice Location Address:

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Directions to “SUMMIT REHAB ” Practice Location

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