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General NPI Number Information
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NPI Number | 1760992465
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Entity Type | Organization
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Legal Business Name | TEXAS UNITED REHAB THERAPY SPECIALISTS LLC
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Dates
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Enumeration Date | 10/07/2017
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Last Update Date | 06/05/2020
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Provider Practice Location Address
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Address Line | 20079 STONE OAK PKWY STE 1230
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City | SAN ANTONIO
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State | TX
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Zip | 78258-6957
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Country | US
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Telephone | 210-236-0911
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Fax | 210-899-0912
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Provider Business Mailing Address
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Address Line | 20079 STONE OAK PKWY STE 1230
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City | SAN ANTONIO
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State | TX
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Zip | 78258-6957
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Country | US
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Telephone | 210-236-0911
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Fax | 210-899-0912
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | OLADIPUPO A. MUSTAPHA
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Credential | PT
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Telephone | 210-236-0911
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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 | 1248635
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License Number State | TX
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