MEDICARE: SURGE MOBILE PHYSICAL THERAPY 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1508411299
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SURGE MOBILE PHYSICAL THERAPY PLLC

Provider Business Mailing Address
First Line	:	7135 N EXPRESSWAY 77 STE B
Second Line	:
City	:	OLMITO
State	:	TX
Zip	:	78575-5313
Country	:	US
Telephone Number	:	956-413-7799
Fax Number	:	956-815-2019

Provider Business Practice Location Address
First Line	:	1765 W STATE HWY 100
Second Line	:
City	:	PORT ISABEL
State	:	TX
Zip	:	78578-2804
Country	:	US
Telephone Number	:	956-443-3844
Fax Number	:

Authorized Official
Title or Position	:	CO-OWNER
Name	:	ROCIO MARTINEZ
Credential	:	PT, DPT
Telephone Number	:	210-815-4383

Provider Enumeration Date	:	08/08/2019
Last Update Date	:	03/10/2026

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