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General NPI Number Information
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NPI Number | 1013163377
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Entity Type | Organization
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Legal Business Name | EPIC PEDIATRIC THERAPY, LP.
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Dates
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Enumeration Date | 08/18/2008
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 1351 E BARDIN RD STE 160
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City | ARLINGTON
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State | TX
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Zip | 76018-2137
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Country | US
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Telephone | 177-951-2918
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Fax | 817-698-9506
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Provider Business Mailing Address
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Address Line | 400 INTERSTATE NORTH PKWY SE STE 1600
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City | ATLANTA
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State | GA
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Zip | 30339-5047
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Country | US
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Telephone | 470-464-8000
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MATTHEW BUCKHALTER
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Credential |
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Telephone | 470-464-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number | 67-6535
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License Number State | TX
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