Healthcare Provider Details

I. General information

NPI: 1619993904
Provider Name (Legal Business Name): GREEN OAKS PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 12/08/2022
Certification Date: 12/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1424 AIRPORT FWY SUITE U
BEDFORD TX
76022-6787
US

IV. Provider business mailing address

3824 S CARRIER PKWY SUITE 470
GRAND PRAIRIE TX
75052-6644
US

V. Phone/Fax

Practice location:
  • Phone: 817-585-0390
  • Fax: 817-858-0842
Mailing address:
  • Phone: 972-262-9972
  • Fax: 972-262-9986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation 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