Healthcare Provider Details

I. General information

NPI: 1992125447
Provider Name (Legal Business Name): XZACT THERAPY AND AQUATICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2014
Last Update Date: 09/15/2022
Certification Date: 09/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1675 NE LOOP 286
PARIS TX
75460-2219
US

IV. Provider business mailing address

1675 NE LOOP 286
PARIS TX
75460-2219
US

V. Phone/Fax

Practice location:
  • Phone: 903-782-9922
  • Fax: 903-784-8384
Mailing address:
  • Phone: 903-782-9922
  • Fax: 903-784-8384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: ZACHARY S MICHAEL
Title or Position: PRESIDENT
Credential:
Phone: 903-782-9922