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General NPI Number Information
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NPI Number | 1174412761
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Entity Type | Organization
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Legal Business Name | THERAREHAB AND WELLNESS
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Dates
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Enumeration Date | 06/30/2025
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 4300 N CENTRAL EXPY STE 325
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City | DALLAS
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State | TX
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Zip | 75206-6507
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Country | US
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Telephone | 469-249-6507
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Fax | 469-249-3510
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Provider Business Mailing Address
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Address Line | 4740 14TH ST STE T3
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City | PLANO
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State | TX
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Zip | 75074-7318
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Country | US
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Telephone | 469-249-9948
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Fax | 469-249-3510
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Authorized Official
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Title or Position | OWNER
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Name | MARK ANTHONY RODRIGUEZ
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Credential |
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Telephone | 915-276-0355
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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