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General NPI Number Information
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NPI Number | 1851851984
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Entity Type | Organization
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Legal Business Name | 423 THERAPY PLLC
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Dates
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Enumeration Date | 03/24/2019
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Last Update Date | 04/19/2023
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Provider Practice Location Address
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Address Line | 6850 MANHATTAN BLVD STE 300-1
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City | FORT WORTH
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State | TX
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Zip | 76120-1227
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Country | US
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Telephone | 469-698-6934
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Fax | 972-692-8485
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Provider Business Mailing Address
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Address Line | PO BOX 822642
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76182-2642
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | ANTHONY CIRAULO
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Credential |
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Telephone | 808-238-9177
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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