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General NPI Number Information
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NPI Number | 1154998896
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Entity Type | Organization
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Legal Business Name | DTX INJURY REHAB LLC
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Dates
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Enumeration Date | 06/10/2021
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Last Update Date | 06/10/2021
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Provider Practice Location Address
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Address Line | 13450 INWOOD RD STE 100
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City | DALLAS
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State | TX
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Zip | 75244-5324
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Country | US
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Telephone | 609-442-4110
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Fax |
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Provider Business Mailing Address
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Address Line | 13450 INWOOD RD
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City | DALLAS
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State | TX
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Zip | 75244-5328
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Country | US
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Telephone | 609-442-4110
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DIEU LINH NGUYEN
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Credential | PA-C
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Telephone | 609-442-4110
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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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 | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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