Healthcare Provider Details

I. General information

NPI: 1720026123
Provider Name (Legal Business Name): MATRIX REHABILITATION-TEXAS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2006
Last Update Date: 07/26/2022
Certification Date: 07/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8204 STONEBROOK PKWY
FRISCO TX
75034-5536
US

IV. Provider business mailing address

335 ROSELANE ST NW SUITE 201
MARIETTA GA
30060-7902
US

V. Phone/Fax

Practice location:
  • Phone: 972-335-1407
  • Fax: 972-335-1408
Mailing address:
  • Phone: 470-259-5226
  • Fax: 267-321-2044

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA L. GOLDBERG
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 610-644-7824