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General NPI Number Information
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NPI Number | 1780490680
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Entity Type | Organization
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Legal Business Name | PHYSICAL REHAB PLLC
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Dates
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Enumeration Date | 12/05/2024
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Last Update Date | 12/05/2024
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Provider Practice Location Address
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Address Line | 200 MEDICAL PKWY STE 110
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City | LAKEWAY
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State | TX
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Zip | 78738-1792
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Country | US
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Telephone | 512-654-0150
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Fax |
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Provider Business Mailing Address
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Address Line | 12856 N HWY 183 STE B2024
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City | AUSTIN
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State | TX
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Zip | 78750-3222
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Country | US
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Telephone | 504-251-1108
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FARHEEN ARSHIA KHAN
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Credential | DO
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Telephone | 504-251-1108
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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