MEDICARE: GOLD STAR PHYSICAL THERAPY LLC

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	2251C2600X	Cardiopulmonary Physical Therapist

General Provider Information

NPI Number	:	1336735687
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLD STAR PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	2651 CRIMSON CANYON DR STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0843
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2651 CRIMSON CANYON DR STE 120
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-0843
Country	:	US
Telephone Number	:	314-629-2150
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	FAYNELLA MARIE TIU
Credential	:	PT
Telephone Number	:	314-629-2150

Provider Enumeration Date	:	12/21/2020
Last Update Date	:	01/19/2021

Similar Medicare Providers

1952925943 — AACG LLC
Practice Location Address:

2640 SUNSET PL
LAS CRUCES, NM
88011-0843

Practice Phone: 520-260-6818
Practice Fax:

1558592493 — GOOD SHEPHERD REHABILITATION RESEARCH INSTITUTE INC.
Practice Location Address:

7455 W. WASHINGTON AVE. , SUITE# 185
LAS VEGAS, NV
89128

Practice Phone: 702-893-3333
Practice Fax: 702-893-0960

1841365723 — GOOD SHEPHERD HEALTHCARE LLC
Practice Location Address:

2451 SOUTH BUFFALO DRIVE SUITE 100
LAS VEGAS, NV
89117-2749

Practice Phone: 702-380-1060
Practice Fax: 702-380-1081

1760558696 — GOOD SHEPHERD HEALTHCARE II LLC
Practice Location Address:

4275 BURNHAM AVENUE SUITE 255
LAS VEGAS, NV
89119-8204

Practice Phone: 702-893-3333
Practice Fax: 702-893-0960

1164605044 — GOOD SHEPHERD REHABILITATION INSTITUTE INC.
Practice Location Address:

2235 E FLAMINGO RD STE 170
LAS VEGAS, NV
89119-5186

Practice Phone: 725-333-7149
Practice Fax: 702-893-0960

1053594937 — GOOD SHEPHERD REHAB CENTERS OF LAS VEGAS INC
Practice Location Address:

2235 E FLAMINGO ROAD , SUITE 170
LAS VEGAS, NV
89119

Practice Phone: 702-380-1060
Practice Fax: 702-380-1081

Directions to “GOLD STAR PHYSICAL THERAPY LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.