MEDICARE: NORTH TEXAS REHABILITATION CENTER, INC.

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	604700000	TX
2	235Z00000X	Speech-Language Pathologist	102098	TX
3	225X00000X	Occupational Therapist	508250000	TX
4	101YP2500X	Professional Counselor	TX62963	TX
5	261QR0400X	Rehabilitation Clinic/Center

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1669475885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH TEXAS REHABILITATION CENTER, INC.

Provider Business Mailing Address
First Line	:	1005 MIDWESTERN PKWY
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76302-2211
Country	:	US
Telephone Number	:	940-322-0771
Fax Number	:	940-766-4943

Provider Business Practice Location Address
First Line	:	1005 MIDWESTERN PKWY
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76302-2211
Country	:	US
Telephone Number	:	940-322-0771
Fax Number	:	940-766-4943

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. SANDRA ROSS
Credential	:
Telephone Number	:	940-687-4932

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	09/05/2025

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1005 MIDWESTERN PKWY
WICHITA FALLS, TX
76302-2211