MEDICARE: MATRIX REHABILITATION - TEXAS, 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	261QP2000X	Physical Therapy Clinic/Center		TX

General Provider Information

NPI Number	:	1790880102
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATRIX REHABILITATION - TEXAS, INC.

Provider Business Mailing Address
First Line	:	2300 COIT RD
Second Line	:	SUITE 300
City	:	PLANO
State	:	TX
Zip	:	75075-3768
Country	:	US
Telephone Number	:	469-467-8705
Fax Number	:	267-321-2550

Provider Business Practice Location Address
First Line	:	3838 OAK LAWN AVE
Second Line	:	SUITE 171
City	:	DALLAS
State	:	TX
Zip	:	75219-4520
Country	:	US
Telephone Number	:	214-526-2690
Fax Number	:	214-526-4655

Authorized Official
Title or Position	:	COMPLIANCE COORDINATOR
Name	:	MR. DENNIS J. FITZPATRICK
Credential	:
Telephone Number	:	610-644-7824

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	08/22/2020

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