MEDICARE: REHAB CONSULTANTS INC

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	1043453	TX
2	225100000X	Physical Therapist	1065415	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	86336T	OTHER		BCBS

General Provider Information

NPI Number	:	1588774897
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHAB CONSULTANTS INC

Provider Business Mailing Address
First Line	:	1617 PARK PLACE AVE
Second Line	:	STE 110
City	:	FT WORTH
State	:	TX
Zip	:	76110-1300
Country	:	US
Telephone Number	:	817-923-1800
Fax Number	:	817-923-2059

Provider Business Practice Location Address
First Line	:	1617 PARK PLACE AVE
Second Line	:	STE 110
City	:	FT WORTH
State	:	TX
Zip	:	76110-1300
Country	:	US
Telephone Number	:	817-923-1800
Fax Number	:	817-923-2059

Authorized Official
Title or Position	:	PHYSICAL THERAPIST
Name	:	MR. ROBERT L LARSON
Credential	:	LPT
Telephone Number	:	817-923-1800

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	08/22/2020

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Directions to “REHAB CONSULTANTS INC ” Practice Location

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