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General NPI Number Information
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NPI Number | 1578979183
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Entity Type | Organization
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Legal Business Name | TRI-PHYSICAL THERAPY AND WELLNESS CENTER LLC
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Dates
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Enumeration Date | 07/02/2014
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Last Update Date | 12/09/2014
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Provider Practice Location Address
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Address Line | 4555 E UNIVERSITY BLVD STE C7
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City | ODESSA
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State | TX
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Zip | 79762-8137
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Country | US
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Telephone | 432-557-5267
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Fax |
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Provider Business Mailing Address
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Address Line | 4555 E UNIVERSITY BLVD STE C7
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City | ODESSA
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State | TX
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Zip | 79762-8137
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Country | US
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Telephone | 432-557-5267
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/CEO
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Name | MR. ALFONSO SALINAS GARCIA JR.
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Credential | PT, OCS, FAAOMPT
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Telephone | 432-614-1987
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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 | 1167253
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License Number State | TX
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