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General NPI Number Information
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NPI Number | 1063947117
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Entity Type | Organization
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Legal Business Name | METROPLEX INTEGRATIVE REHABILITATION SERVICES
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Dates
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Enumeration Date | 04/26/2017
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Last Update Date | 09/20/2018
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Provider Practice Location Address
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Address Line | 4441 BRYANT IRVIN RD N.
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City | FORT WORTH
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State | TX
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Zip | 76107
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Country | US
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Telephone | 817-921-3000
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Fax | 817-921-3001
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Provider Business Mailing Address
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Address Line | 4441 BRYANT IRVIN RD N.
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City | FORT WORTH
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State | TX
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Zip | 76107
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Country | US
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Telephone | 817-921-3000
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Fax | 817-921-3001
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Authorized Official
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Title or Position | CHIEF OF ADMINISTRATION
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Name | TERESA MARTIN
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Credential |
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Telephone | 817-921-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LX0106X
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Taxonomy Name | Occupational Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 103TR0400X
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Taxonomy Name | Rehabilitation Psychologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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