Xtreme Medical Rehab

Primary specialty

Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X

License

N6762 Issued in TX

Legal business name

XTREME MEDICAL REHAB

Doing business as

DFW Medical Pain & Rehab

Practice address

1710 Rufe Snow Dr
120
Keller, TX 76248-5745

Phone

(817) 656-1615

Fax

(817) 428-0573

NPI assigned

Dec 21, 2016

Last updated

Dec 21, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jason Wander, D.O.

Title

President

Phone

(817) 656-1615

Specialties & licenses 2

Addresses

Other names 1

• DFW Medical Pain & Rehab Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Arthur Michael Gray, D.C.

  • Chiropractor
  • Keller, TX
  • NPI 1487765806

  Single Specialty

  NPD
• Jordan Pastorek, MD

  • Internal Medicine Physician
  • Frisco, TX
  • NPI 1265400634
  NPD (past)

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

{
    "created_epoch": "1482278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1482278400000",
    "number": "1043755457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1710 RUFE SNOW DR",
            "address_2": "120",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762485745",
            "telephone_number": "817-656-1615",
            "fax_number": "817-428-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 RUFE SNOW DR",
            "address_2": "120",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "762485745",
            "telephone_number": "817-656-1615",
            "fax_number": "817-428-0573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "XTREME MEDICAL REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-21",
        "last_updated": "2016-12-21",
        "status": "A",
        "authorized_official_last_name": "WANDER",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-656-1615",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N6762",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": "TX",
            "license": "N6762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DFW Medical Pain & Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Wort Wellbeing Women's Clinic, PLLC
• Wound Care Werx PLLC
• Laura Melissa Wright, LPC
• William Wright, LCSW
• Guanru Wu, L.AC
• Fan Yang, D.P.T.
• Savanah Yates
• Dominique Ajae Young
• Kiondria Youngblood
• Zahra Merchant MD PLLC

• Sports Medicine (Family Medicine) Physician in Keller, TX
• Providers in Keller, TX by specialty
• Sports Medicine (Family Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2016; 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.