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General NPI Number Information
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NPI Number | 1316295678
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Entity Type | Organization
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Legal Business Name | CORPUS CHRISTI PHYSICAL THERAPY AND SPORTS MEDICINE CENTER LLC
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Dates
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Enumeration Date | 08/16/2012
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Last Update Date | 09/18/2012
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Provider Practice Location Address
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Address Line | 5959 S STAPLES ST SUITE 105
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City | CORPUS CHRISTI
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State | TX
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Zip | 78413-3846
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Country | US
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Telephone | 361-994-5251
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Fax | 361-994-5257
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Provider Business Mailing Address
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Address Line | PO BOX 6936
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City | CORPUS CHRISTI
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State | TX
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Zip | 78466-6936
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Country | US
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Telephone | 361-994-5251
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Fax | 361-994-5257
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Authorized Official
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Title or Position | DIRECTOR
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Name | LEE C GLOVER
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Credential | P.T.
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Telephone | 361-549-9108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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