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General NPI Number Information
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NPI Number | 1992192512
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Entity Type | Organization
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Legal Business Name | BAYLOR INSTITUTE FOR REHABILITATION
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Dates
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Enumeration Date | 04/21/2015
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Last Update Date | 04/21/2015
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Provider Practice Location Address
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Address Line | 4347 W NORTHWEST HWY SUITE 180
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City | DALLAS
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State | TX
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Zip | 75220-3864
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Country | US
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Telephone | 214-654-0947
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Fax | 214-654-0956
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Provider Business Mailing Address
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Address Line | 4347 W NORTHWEST HWY SUITE 180
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City | DALLAS
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State | TX
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Zip | 75220-3864
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Country | US
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Telephone | 214-654-0947
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Fax | 214-654-0956
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | MARIKA C CROCKETT
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Credential | DPT
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Telephone | 512-657-5104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283X00000X
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Taxonomy Name | Rehabilitation Hospital
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License Number | 1203197
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License Number State | TX
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