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General NPI Number Information
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NPI Number | 1841220068
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Entity Type | Organization
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Legal Business Name | COOPER & BUSH PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 07/04/2006
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Last Update Date | 02/25/2021
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Provider Practice Location Address
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Address Line | 6080 SOUTHWEST BLVD
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City | BENBROOK
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State | TX
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Zip | 76109-3912
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Country | US
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Telephone | 817-731-9331
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Fax | 817-731-9882
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Provider Business Mailing Address
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Address Line | 6080 SOUTHWEST BLVD
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City | BENBROOK
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State | TX
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Zip | 76109-3912
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Country | US
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Telephone | 817-731-9331
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Fax | 817-731-9882
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | NATALIE M BUSH
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Credential |
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Telephone | 817-731-9331
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 521500000
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 609990000
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License Number State | TX
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