=====================================================
General NPI Number Information
=====================================================
NPI Number | 1790559466
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SAPPHIRE HEALTH & REHABILITATION, PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/13/2023
-----------------------------------------------------
Last Update Date | 05/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3600 S LOOP 340
-----------------------------------------------------
City | ROBINSON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76706-4828
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-970-6817
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6500 VIRGINIA SQ
-----------------------------------------------------
City | ARLINGTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76017-4947
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 817-996-9720
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. DOMINIQUE CHRISTIANA VAN BEEST
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 214-970-6817
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------