MEDICARE: TEXAS SPORTS 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	2255A2300X	Athletic Trainer

General Provider Information

NPI Number	:	1407840275
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TEXAS SPORTS REHAB

Provider Business Mailing Address
First Line	:	6901 SNIDER PLZ
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75205-5648
Country	:	US
Telephone Number	:	214-369-7757
Fax Number	:	214-369-5544

Provider Business Practice Location Address
First Line	:	6901 SNIDER PLZ
Second Line	:	SUITE 100
City	:	DALLAS
State	:	TX
Zip	:	75205-5648
Country	:	US
Telephone Number	:	214-369-7757
Fax Number	:	214-369-5544

Authorized Official
Title or Position	:	MANAGER
Name	:	JOSH BERNSTEIN
Credential	:	M.ED, ATC
Telephone Number	:	214-369-7757

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	08/22/2020

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Directions to “TEXAS SPORTS REHAB ” Practice Location

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