MEDICARE: RESILIENT PELVIC SOLUTIONS 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1902686157
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RESILIENT PELVIC SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	301 SILVERON APT 5301
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75028-4121
Country	:	US
Telephone Number	:	646-915-2549
Fax Number	:	469-645-2041

Provider Business Practice Location Address
First Line	:	2201 SPINKS RD STE 247
Second Line	:
City	:	FLOWER MOUND
State	:	TX
Zip	:	75022-4499
Country	:	US
Telephone Number	:	214-425-0236
Fax Number	:	469-645-2041

Authorized Official
Title or Position	:	OWNER
Name	:	AMGED GAD
Credential	:	PT. DPT.
Telephone Number	:	646-915-2549

Provider Enumeration Date	:	10/04/2023
Last Update Date	:	10/10/2023

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