Healthcare Provider Details

I. General information

NPI: 1891592192
Provider Name (Legal Business Name): NEXT STEP MOBILE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2025
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 FUENTE
IRVING TX
75039-3408
US

IV. Provider business mailing address

448 FUENTE
IRVING TX
75039-3408
US

V. Phone/Fax

Practice location:
  • Phone: 940-642-2966
  • Fax:
Mailing address:
  • Phone: 940-642-2966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251E1200X
TaxonomyErgonomics Physical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. JERROD TYLER MELENDEZ
Title or Position: MANAGER
Credential: PTA
Phone: 940-642-2966