Healthcare Provider Details

I. General information

NPI: 1144816653
Provider Name (Legal Business Name): BEX PHYSICAL THERAPY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2020
Last Update Date: 02/01/2021
Certification Date: 02/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 CHAMPION DR
WYLIE TX
75098-4640
US

IV. Provider business mailing address

218 CHAMPION DR
WYLIE TX
75098-4640
US

V. Phone/Fax

Practice location:
  • Phone: 469-484-6812
  • Fax: 469-519-1612
Mailing address:
  • Phone: 469-484-6812
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: REBECCA C SENIZAIZ
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: DPT
Phone: 469-484-6812