Organization · NPI-2

Physiatry Service Organization, INC.

Physical Medicine & Rehabilitation · Rockwall, TX

NPI number1376698944
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1376698944
Entity type
Organization (NPI-2)
Legal business name
Physiatry Service Organization, INC.
Organization subpart
No
Enumeration date
Jan 24, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208100000X Physical Medicine & Rehabilitation––Yes

Practice location

103 N 1st St
Rockwall, TX 75087-3033

Phone 214-403-3959 · Fax 817-284-3505

Mailing address

Po Box 678413
Dallas, TX 75267-8413

Phone 214-403-3959 · Fax 817-284-3505

Authorized official

Gwen A. Fields
Secretary
2144033959

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