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General NPI Number Information
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NPI Number | 1376670265
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Entity Type | Organization
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Legal Business Name | FEDERAL ROAD REHAB & DIAGNOSTIC INC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/22/2013
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Provider Practice Location Address
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Address Line | 12655 WOODFOREST BLVD STE 100
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City | HOUSTON
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State | TX
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Zip | 77015-3575
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Country | US
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Telephone | 713-455-2535
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Fax | 713-451-1411
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Provider Business Mailing Address
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Address Line | 12655 WOODFOREST BLVD SUITE #100
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City | HOUSTON
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State | TX
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Zip | 77015-3564
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Country | US
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Telephone | 713-455-2535
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Fax | 713-451-1411
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM J KOWALSKI
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Credential | DC
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Telephone | 713-451-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | 2889
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1013647
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License Number State | TX
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