Healthcare Provider Details
I. General information
NPI: 1578597589
Provider Name (Legal Business Name): GREEN OAKS PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/10/2006
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5833 W I-20
ARLINGTON TX
76017-1057
US
IV. Provider business mailing address
3824 S CARRIER PKWY SUITE 470
GRAND PRAIRIE TX
75052-6644
US
V. Phone/Fax
- Phone: 817-516-1115
- Fax: 817-516-1104
- Phone: 972-262-9972
- Fax: 972-262-9986
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0401X |
| Taxonomy | Comprehensive Outpatient Rehabilitation Facility (CORF) |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
BINSTEIN
Title or Position: VP,AUTHORIZED OFFICIAL
Credential: JD
Phone: 713-297-7000