Healthcare Provider Details

I. General information

NPI: 1699293753
Provider Name (Legal Business Name): CHSR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2017
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6950 STADIUM LN
FRISCO TX
75033-2076
US

IV. Provider business mailing address

6950 STADIUM LN
FRISCO TX
75033-2076
US

V. Phone/Fax

Practice location:
  • Phone: 469-303-2508
  • Fax: 469-303-4076
Mailing address:
  • Phone: 469-303-2508
  • Fax: 469-303-4076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT S FRIES
Title or Position: PRESIDENT
Credential:
Phone: 214-456-0299