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General NPI Number Information
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NPI Number | 1265495816
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Entity Type | Organization
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Legal Business Name | NEUROMUSCULOSKELETAL REHABILITATION MEDICINE CONSULTANT
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 11/25/2024
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Provider Practice Location Address
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Address Line | 3600 MAPLESHADE LN
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City | PLANO
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State | TX
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Zip | 75075-5715
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Country | US
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Telephone | 972-849-0164
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Fax | 972-999-4634
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Provider Business Mailing Address
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Address Line | 7750 N MACARTHUR BLVD STE 120-338
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City | IRVING
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State | TX
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Zip | 75063-7514
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Country | US
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Telephone | 817-284-9850
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Fax | 949-863-6838
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | LISA M LEE
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Credential |
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Telephone | 817-284-9850
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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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