MEDICARE: EMPOWER PHYSICAL THERAPY TX 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	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1588205033
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EMPOWER PHYSICAL THERAPY TX LLC

Provider Business Mailing Address
First Line	:	4050 E COTTON CENTER BLVD STE 18
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85040-8862
Country	:	US
Telephone Number	:	480-653-8200
Fax Number	:	602-296-5622

Provider Business Practice Location Address
First Line	:	8150 BOULEVARD 26
Second Line	:
City	:	NORTH RICHLAND HILLS
State	:	TX
Zip	:	76180-7202
Country	:	US
Telephone Number	:	817-498-8585
Fax Number	:	817-576-4157

Authorized Official
Title or Position	:	CEO/OWNER
Name	:	STEVEN DIPAOLA
Credential	:	PT
Telephone Number	:	480-653-8191

Provider Enumeration Date	:	10/07/2019
Last Update Date	:	11/27/2023

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