Healthcare Provider Details

I. General information

NPI: 1811374077
Provider Name (Legal Business Name): NM REHAB & WELLNESS CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2015
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3620 N JOSEY LN STE 118
CARROLLTON TX
75007-3139
US

IV. Provider business mailing address

2220 COIT ROAD SUITE 480 - 203
PLANO TX
75075-5773
US

V. Phone/Fax

Practice location:
  • Phone: 214-764-0759
  • Fax:
Mailing address:
  • Phone: 214-764-0759
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: B P
Title or Position: VP
Credential:
Phone: 214-764-0759