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General NPI Number Information
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NPI Number | 1265718084
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Entity Type | Organization
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Legal Business Name | AWAD REHABILITATION
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Dates
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Enumeration Date | 10/25/2011
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Last Update Date | 10/25/2011
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Provider Practice Location Address
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Address Line | 3110 LAMESA DR
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City | GARLAND
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State | TX
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Zip | 75041-4201
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Country | US
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Telephone | 972-278-3511
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Fax | 972-278-8386
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Provider Business Mailing Address
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Address Line | 3110 LAMESA DR
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City | GARLAND
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State | TX
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Zip | 75041-4201
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Country | US
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Telephone | 972-278-3511
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Fax | 972-278-8386
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Authorized Official
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Title or Position | OWNER
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Name | ISSAM AWAD
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Credential |
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Telephone | 214-382-1909
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number | K2755
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License Number State | TX
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