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General NPI Number Information
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NPI Number | 1497663025
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Entity Type | Organization
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Legal Business Name | OSTEOPRACTIC PHYSICAL THERAPY OF EAST TEXAS, LLC
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Dates
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Enumeration Date | 09/01/2026
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Last Update Date | 09/01/2026
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Provider Practice Location Address
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Address Line | 2825 NALL ST STE 13
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City | PORT NECHES
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State | TX
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Zip | 77651-5215
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Country | US
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Telephone | 281-850-5955
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Fax |
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Provider Business Mailing Address
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Address Line | 1329 HORRIDGE ST
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City | VINTON
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State | LA
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Zip | 70668-4531
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Country | US
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Telephone | 281-850-5955
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/PHYSICAL THERAPIST
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Name | DR. RUSSELL W HEARNE
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Credential | PT, DPT
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Telephone | 281-850-5955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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