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General NPI Number Information
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NPI Number | 1396785184
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Entity Type | Organization
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Legal Business Name | MATRIX REHABILITATION-TEXAS, INC.
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 12/04/2015
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Provider Practice Location Address
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Address Line | 438 E HIGHWAY 67
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City | DUNCANVILLE
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State | TX
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Zip | 75137-4157
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Country | US
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Telephone | 972-709-6393
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Fax | 972-709-6494
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Provider Business Mailing Address
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Address Line | 335 ROSELANE ST NW SUITE 201
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City | MARIETTA
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State | GA
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Zip | 30060-7902
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Country | US
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Telephone | 470-259-5226
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Fax | 267-321-2044
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Authorized Official
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Title or Position | CHIEF COMPLIANCE OFFICER
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Name | CYNTHIA L. GOLDBERG
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Credential |
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Telephone | 610-644-7824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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