Healthcare Provider Details

I. General information

NPI: 1487998498
Provider Name (Legal Business Name): CAREPATH THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 05/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

720 W. NATHAN LOWE RD, #150
ARLINGTON TX
76017
US

IV. Provider business mailing address

720 W. NATHAN LOWE ROAD #150
ARLINGTON TX
76017
US

V. Phone/Fax

Practice location:
  • Phone: 817-472-4344
  • Fax: 817-472-4341
Mailing address:
  • Phone: 817-472-4344
  • Fax: 817-472-4341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number1195461
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number719954
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number1195461
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number StateTX

VIII. Authorized Official

Name: GEORGE O NWORA
Title or Position: ADMINISTRATOR
Credential: RN,MSN
Phone: 817-472-4344