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NPI Code Detail

MEDICARE: LAMESA PHYSICAL THERAPY AND SPORTS REHAB, PLLC

MEDICARE: LAMESA PHYSICAL THERAPY AND SPORTS REHAB, PLLC
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
1225100000XPhysical Therapist1262686TX

General Provider Information

NPI Number : 1205346541
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAMESA PHYSICAL THERAPY AND SPORTS REHAB, PLLC
Provider Business Mailing Address
First Line : 221 N MAIN AVE
Second Line :
City : LAMESA
State : TX
Zip : 79331-5533
Country : US
Telephone Number : 806-200-5030
Fax Number : 806-370-6484
Provider Business Practice Location Address
First Line : 221 N MAIN AVE
Second Line :
City : LAMESA
State : TX
Zip : 79331-5533
Country : US
Telephone Number : 806-759-1483
Fax Number : 806-370-6484
Authorized Official
Title or Position : PHYSICAL THERAPIST
Name : JOSHUA FREITAG
Credential : PT, DPT
Telephone Number : 806-759-1483
Provider Enumeration Date : 09/30/2017
Last Update Date : 03/10/2026

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