MEDICARE: RIVERCHASE REHAB & WELLNESS PA

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	1072528	TX
2	111N00000X	Chiropractor	5943	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0035JQ	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1578677332
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVERCHASE REHAB & WELLNESS PA

Provider Business Mailing Address
First Line	:	870 S DENTON TAP RD STE 200
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-4575
Country	:	US
Telephone Number	:	972-393-3737
Fax Number	:	972-393-4925

Provider Business Practice Location Address
First Line	:	870 S DENTON TAP RD STE 200
Second Line	:
City	:	COPPELL
State	:	TX
Zip	:	75019-4575
Country	:	US
Telephone Number	:	972-393-3737
Fax Number	:	972-393-4925

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DOUG E BEDICHEK
Credential	:	D.C.
Telephone Number	:	972-393-3737

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	03/11/2026

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1508816893 — DR. DOUGLAS E BEDICHEK D.C.
Practice Location Address:

870 S DENTON TAP RD STE 200
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1134121288 — DR. RUSSELL KING BASS D.D.S.
Practice Location Address:

220 S DENTON TAP RD , STE 101
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1366447211 — DR. SHAROLYN K. DIHIGO DNP, RN, CPNP, FNP-C
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1073518957 — TAMMI LYN SCHLICHTEMEIER MD
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Directions to “RIVERCHASE REHAB & WELLNESS PA ” Practice Location

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