Healthcare Provider Details

I. General information

NPI: 1144959826
Provider Name (Legal Business Name): OPAL MOVEMENT THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5616 CORSO CT
AUSTIN TX
78747-4482
US

IV. Provider business mailing address

5616 CORSO CT
AUSTIN TX
78747-4482
US

V. Phone/Fax

Practice location:
  • Phone: 512-461-3435
  • Fax:
Mailing address:
  • Phone: 512-461-3435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. MORGAN CLAIRE RIGGINS
Title or Position: DOCTOR OF PHYSICAL THERAPY
Credential: PT
Phone: 512-461-3435