NPIMap

Organization Active NPI

Killeen Injury Clinic, Inc.

  • Physical Therapist
  • Killeen, TX
National Provider Identifier
1134326739
Registry record updated Apr 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1030278 Issued in TX
Legal business name
KILLEEN INJURY CLINIC, INC.
Practice address
100 E Central Texas Expy
Suite 100
Killeen, TX 76541-8525
Phone
(254) 501-3555
Fax
(254) 501-3554
NPI assigned
Jun 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2009

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

Authorized official

Name
Mr. Nat Mangum
Title
Ceo
Phone
(469) 688-6628

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X 14136 TX
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X J1957 TX
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 1030278 TX Primary

Addresses

Primary practice location

100 E Central Texas Expy
Suite 100
Killeen, TX 76541-8525

Mailing address

5931 Desco Drive
Dallas, TX 75225
Phone (214) 692-6666

National Provider Directory

National Provider Directory

Locations

100 E Central Texas Expy
Ste 100
Killeen, TX 76541
Phone (254) 501-3555

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1182988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240358400000",
    "number": "1134326739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5931 DESCO DRIVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75225",
            "telephone_number": "214-692-6666",
            "fax_number": "214-692-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CENTRAL TEXAS EXPY",
            "address_2": "SUITE 100",
            "city": "KILLEEN",
            "state": "TX",
            "postal_code": "765418525",
            "telephone_number": "254-501-3555",
            "fax_number": "254-501-3554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KILLEEN INJURY CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-28",
        "last_updated": "2009-04-22",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "NAT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "469-688-6628",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "14136",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "TX",
            "license": "J1957",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1030278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Killeen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.