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NPI Code Detail

MEDICARE: SPORTCARE REHABILITATION INC

MEDICARE: SPORTCARE REHABILITATION 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
1225100000XPhysical TherapistTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
180350TOTHERTXBCBS PROVIDER NUMBER

General Provider Information

NPI Number : 1295816965
Entity Type Code : Organization
Provider Name (Legal Business Name) : SPORTCARE REHABILITATION INC
Provider Business Mailing Address
First Line : 4750 BRYANT IRVIN RD N
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-7641
Country : US
Telephone Number : 817-923-9000
Fax Number : 817-923-9033
Provider Business Practice Location Address
First Line : 4750 BRYANT IRVIN RD N
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-7641
Country : US
Telephone Number : 817-923-9000
Fax Number : 817-923-9033
Authorized Official
Title or Position : OWNER
Name : DENNIS J CURNYN
Credential : P.T.
Telephone Number : 817-923-9000
Provider Enumeration Date : 10/18/2006
Last Update Date : 08/22/2020

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1285288373 — HILLARY HUMMEL-KERBS PT, DPT
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Directions to “SPORTCARE REHABILITATION INC ” Practice Location

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