Healthcare Provider Details

I. General information

NPI: 1437201308
Provider Name (Legal Business Name): KAUFMAN PHYSICAL THERAPY AND REHABILITATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 04/01/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 E US HIGHWAY 175 SUITE B
CRANDALL TX
75114-2545
US

IV. Provider business mailing address

PO BOX 337
KAUFMAN TX
75142-0337
US

V. Phone/Fax

Practice location:
  • Phone: 972-932-8599
  • Fax: 972-932-8571
Mailing address:
  • Phone: 972-932-8599
  • Fax: 972-932-8571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number6056104
License Number StateTX

VIII. Authorized Official

Name: MR. REZA NABAVI
Title or Position: PRESIDENT
Credential: P.T.
Phone: 972-932-8599