MEDICARE: THERAREHAB AND WELLNESS

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	208100000X	Physical Medicine & Rehabilitation Physician

General Provider Information

NPI Number	:	1174412761
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAREHAB AND WELLNESS

Provider Business Mailing Address
First Line	:	4740 14TH ST STE T3
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-7318
Country	:	US
Telephone Number	:	469-249-9948
Fax Number	:	469-249-3510

Provider Business Practice Location Address
First Line	:	4300 N CENTRAL EXPY STE 325
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-6507
Country	:	US
Telephone Number	:	469-249-6507
Fax Number	:	469-249-3510

Authorized Official
Title or Position	:	OWNER
Name	:	MARK ANTHONY RODRIGUEZ
Credential	:
Telephone Number	:	915-276-0355

Provider Enumeration Date	:	06/30/2025
Last Update Date	:	06/30/2025

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Directions to “THERAREHAB AND WELLNESS ” Practice Location

Language	Start Address	Practice Location

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