MEDICARE: T AND C CONSOLIDATED, 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
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1356688949
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	T AND C CONSOLIDATED, PLLC

Provider Business Mailing Address
First Line	:	701 OAK ST STE C
Second Line	:
City	:	GRAHAM
State	:	TX
Zip	:	76450-3073
Country	:	US
Telephone Number	:	940-549-0788
Fax Number	:

Provider Business Practice Location Address
First Line	:	432 OAK ST
Second Line	:
City	:	GRAHAM
State	:	TX
Zip	:	76450-2522
Country	:	US
Telephone Number	:	940-549-0788
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	CHRISTA CRETORS
Credential	:	PT
Telephone Number	:	940-549-0788

Provider Enumeration Date	:	01/16/2013
Last Update Date	:	10/30/2023

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