Healthcare Provider Details

I. General information

NPI: 1780496844
Provider Name (Legal Business Name): BACK TO THE BASICS SOLUTIONS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19059 STATE HIGHWAY 274
KEMP TX
75143-5382
US

IV. Provider business mailing address

106 HOB O THE HILL ST
GUN BARREL CITY TX
75156-4321
US

V. Phone/Fax

Practice location:
  • Phone: 432-640-9985
  • Fax:
Mailing address:
  • Phone: 432-640-9985
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RENEE CATHERINE MAXWELL
Title or Position: DOCTOR OF PHYSICAL THERAPY
Credential: PT, DPT
Phone: 432-640-9985