NACOGDOCHES PHYSICAL THERAPY LLC (NPI# 1316991441) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316991441 |
| Entity Type | Organization |
| Organization Name | NACOGDOCHES PHYSICAL THERAPY LLC |
| Other Organization Name | NACOGDOCHES PHYSICAL EXELLENCE CENTER |
| Practice Address |
3909 Ne Stalling Drive Nacogdoches TX 75965 |
| Mailing Address |
3909 Ne Stallings Dr Nacogdoches TX 75965-2169 |
| Practice Telephone | 9365647780 |
| Practice Fax Number | 9365640745 |
| Mailing Telephone | 9365647780 |
| Mailing Fax Number | 9365640745 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2011-06-27 |
| Authorized Official Name | MR. MAX H MITCHELL (ADMINISTRATOR) |
| Authorized Official Telephone | 9365647780 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0401X |
Clinic/Center Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 021252401 | 05 | |
| BCBS TX | 00T24Y | 01 |
| Other Name | Type Code |
|---|---|
| Nacogdoches Physical Exellence Center | Doing Business As Name - Organization |
| Street Address |
3909 NE STALLING DRIVE |
| City | NACOGDOCHES |
| State | TX |
| Zip Code | 75965 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649839135 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 3824 N University Drive, Suite 103, Nacogdoches, TX 75965 | 2019-06-10 |
| 1518520493 | Billy Jobe | Pharmacist | 917 East Austin, Nacogdoches, TX 75965 | 2019-04-17 |
| 1295217610 | Sarah Ponder | Registered Nurse | 625 Woodway Lane, Nacogdoches, TX 75965 | 2018-09-01 |
| 1083107684 | Aakash Deep Gupta | Dentist | 4610 North St Ste 101b, Nacogdoches, TX 75965 | 2018-06-08 |
| 1679097455 | Emily Morris Taravella | Counselor | 3524 Ne Stallings Drive, Nacogdoches, TX 75965 | 2017-08-02 |
| 1457809949 | Kassey Osborn | Nurse Practitioner | 4920 Ne Stallings Dr., Nacogdoches Medical Center, Nacogdoches, TX 75965 | 2016-09-14 |
| 1629426747 | Lisa Greathouse | Technician, Other | 500 Chincapin, Westville, OK 75965 | 2016-05-31 |
| 1457741704 | Nuch of Texas | Pediatrics | 1305 North Street, Nacogdoches, TX 75965 | 2015-01-26 |
| 1730506031 | Benjamin Patrick Thompson | Obstetrics & Gynecology | 4800 Ne Stallings Dr Ste 106, Nacogdoches, TX 75965 | 2014-03-25 |
| 1255761813 | Kallie Krawietz | Counselor | 2214 N Pecan Street, Nacogdoches, TX 75965 | 2013-11-19 |
| Find all providers in zip 75965 | ||||
| Taxonomy Code | 261QR0401X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447807615 | Rise Up Rehab, LLC | Clinic/Center | 1687 Old Hwy 90, Castroville, TX 78009 | 2019-08-22 |
| 1346897709 | Rise Up Rehab, LLC | Clinic/Center | 10410 Parrigin Rd, Helotes, TX 78023-4283 | 2019-08-21 |
| 1376016410 | Elite 360 Health and Wellness | Clinic/Center | 1409 S Lamar, Ste. 245, Dallas, TX 75215-6818 | 2019-01-10 |
| 1902333792 | Medcare Pediatric Rehab Center, Lp | Clinic/Center | 21004 Interstate 45 N, Spring, TX 77373-2917 | 2017-05-11 |
| 1023544418 | Medcare Pediatric Rehab Center, Lp | Clinic/Center | 5095 Preston Ave, Pasadena, TX 77505-2053 | 2017-05-04 |
| 1871029264 | Medcare Pediatric Rehab Center, Lp | Clinic/Center | 4818 E Sam Houston Pkwy N, Houston, TX 77015-3240 | 2017-05-04 |
| 1356793509 | Individual | Clinic/Center | 3500 Timberwood Cir Apt 2137, Arlington, TX 76015-3129 | 2016-07-11 |
| 1801242839 | Transitional Learning Center At Galveston | Clinic/Center | 4416 10th St, Lubbock, TX 79416-4800 | 2016-05-09 |
| 1225401805 | Milestones | Clinic/Center | 2704 S 26th St, Mcallen, TX 78503-7812 | 2015-11-04 |
| 1326421173 | Costa Therapy Institute, LLC | Clinic/Center | 1058 Palm Blvd, Brownsville, TX 78520-6168 | 2015-06-29 |
| Find all providers with the same taxonomy | ||||
| City | NACOGDOCHES |
| Zip Code | 75965 |
Please comment or provide details below to improve the information on NACOGDOCHES PHYSICAL THERAPY LLC.
| 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.