MEDICARE: RELIANT PRO REHAB LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1922404664
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELIANT PRO REHAB LLC

Provider Business Mailing Address
First Line	:	5800 GRANITE PKWY STE 1000
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-6619
Country	:	US
Telephone Number	:	972-890-9095
Fax Number	:	866-422-5051

Provider Business Practice Location Address
First Line	:	5800 GRANITE PKWY STE 1000
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-6619
Country	:	US
Telephone Number	:	972-890-9095
Fax Number	:

Authorized Official
Title or Position	:	CHIEF STRATEGY OFFICER
Name	:	DAVID BURTON TATE
Credential	:	PT, DPT
Telephone Number	:	877-889-5188

Provider Enumeration Date	:	11/07/2014
Last Update Date	:	04/20/2022

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Directions to “RELIANT PRO REHAB LLC ” Practice Location

Language	Start Address	Practice Location

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