Healthcare Provider Details

I. General information

NPI: 1508051202
Provider Name (Legal Business Name): PLEXUS TREATMENT CENTERS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 STATE HIGHWAY 206
CISCO TX
76437-6450
US

IV. Provider business mailing address

1510 STATE HIGHWAY 206
CISCO TX
76437-6450
US

V. Phone/Fax

Practice location:
  • Phone: 254-442-4878
  • Fax: 254-442-3754
Mailing address:
  • Phone: 254-442-4878
  • Fax: 254-442-3754

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateTX

VIII. Authorized Official

Name: DR. JOE DEVIN KOENIG
Title or Position: CEO
Credential: D.C.
Phone: 254-442-4878