Capital Sports Rehab, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CAPITAL SPORTS REHAB, PLLC

Practice address

821 Grand Avenue Pkwy Ste 402C
Pflugerville, TX 78660-2197

Phone

(512) 222-8411

NPI assigned

Sep 6, 2019

Organization subpart

No

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

Authorized official

Name

Scalett Gonzalez, PTA

Title

Co-Owner

Phone

(214) 986-9720

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1567728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567728000000",
    "number": "1194374611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13524 CIDERWOOD CT",
            "city": "MANOR",
            "state": "TX",
            "postal_code": "786534108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 GRAND AVENUE PKWY STE 402C",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786602197",
            "telephone_number": "512-222-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAPITAL SPORTS REHAB, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-06",
        "last_updated": "2019-09-06",
        "status": "A",
        "authorized_official_last_name": "GONZALEZ",
        "authorized_official_first_name": "SCALETT",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "214-986-9720",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2019; 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.