PEDI SPOT LLC


Address: 1617 Park Place Ave, #110, Fort Worth, TX 76110-1300
Phone: 8179215020

PEDI SPOT LLC (NPI# 1235338153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235338153
Entity Type Organization
Organization Name PEDI SPOT LLC
Practice Address 1617 Park Place Ave, #110
Fort Worth
TX 76110-1300
Mailing Address 4965 Preston Park Blvd, #200
Plano
TX 75093-3649
Practice Telephone 8179215020
Practice Fax Number 8179215022
Enumeration Date 2007-07-11
Last Update Date 2009-03-31
Authorized Official Name NEIL E. CASEY (PRESIDENT & CEO)
Authorized Official Telephone 9725967700
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QR0400X Clinic/Center
Specialization: Rehabilitation
Ambulatory Health Care Facilities

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1508065426 Pedi Spot LLC Clinic/Center 545 Rowlett Rd, Suite A, Garland, TX 75043-3700 2007-07-11
1215136130 Pedi Spot LLC Clinic/Center 6601 Montana Ave, Suite G&h, El Paso, TX 79925-2155 2007-07-11
1053510974 Pedi Spot LLC Clinic/Center 4801 Troup Hwy, Suite 800, Tyler, TX 75703-2356 2007-07-11
1598964413 Pedi Spot LLC Clinic/Center 98 Briggs St, Suite 990, San Antonio, TX 78224-1287 2007-07-11
1952500878 Pedi Spot LLC Clinic/Center 9607 Research Blvd, Suite 675, Austin, TX 78759-5691 2007-07-11

Office Location

Street Address 1617 PARK PLACE AVE, #110
City FORT WORTH
State TX
Zip Code 76110-1300

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Taxonomy Information

Taxonomy Code 261QR0400X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Rehabilitation

Taxonomy Definition

Definition to come...

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1720247844 David Back Clinic of America Inc Clinic/Center 3800 Hulen St, Suite 110, Fort Worth, TX 76107-7276 2008-06-04

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Competitor

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City FORT WORTH
Zip Code 76110

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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