MEDICARE: AGILITAS USA, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist
2	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1073362703
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AGILITAS USA, INC.

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:

Provider Business Practice Location Address
First Line	:	8323 FM 723 RD STE 107
Second Line	:
City	:	RICHMOND
State	:	TX
Zip	:	77406-8808
Country	:	US
Telephone Number	:	832-615-0527
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	PREET TAKKAR
Credential	:
Telephone Number	:	408-914-8737

Provider Enumeration Date	:	05/15/2024
Last Update Date	:	05/15/2024

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Directions to “AGILITAS USA, INC. ” Practice Location

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