Southwest Sports & Spine V, LLP

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

635850006 Issued in TX

Legal business name

SOUTHWEST SPORTS & SPINE V, LLP

Practice address

3535 Travis St
Suite 160
Dallas, TX 75204-1448

Phone

(214) 346-9105

Fax

(214) 346-9125

NPI assigned

Oct 5, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Craig Rettke

Title

Partner

Phone

(972) 529-3691

Specialties & licenses 1

Addresses

Other names 1

• Vista Physical Therapy Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Vista Rehab Partners, LP

  • Physical Therapist
  • Haltom City, TX
  • NPI 1831435437

  Member Of

  NPD member

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649894400000",
    "number": "1033106984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 W ELDORADO PKWY",
            "address_2": "#102-20KT",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750706510",
            "telephone_number": "214-346-9105",
            "fax_number": "214-346-9125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3535 TRAVIS ST",
            "address_2": "SUITE 160",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752041448",
            "telephone_number": "214-346-9105",
            "fax_number": "214-346-9125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SPORTS & SPINE V, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-05",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A",
        "authorized_official_last_name": "RETTKE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "972-529-3691"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "635850006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southwest Personal Care
• Southwest Podiatry, LLP
• Southwest Podiatry, LLP
• Southwest Professional Surgical Associates
• Southwest Pulmonary Associates
• Southwest Sports & Spine, LLP
• Southwest Surgical Oncology Associates
• Southwest Urology Associates
• Southwest Vascular and Surgical Group
• Southwestern Pain Institute, PA

• Physical Therapist in Dallas, TX
• Providers in Dallas, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.