3Jkenterprises
Organization Active NPI Physical Therapy Clinic/Center · Early, TX
NPI 1295261071 · NPPES record last updated May 11, 2017
Key facts
- NPI
- 1295261071
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- 1120111 (TX)
- Legal business name
- 3JKENTERPRISES
- Practice address
- 919 Early Blvd
Suite 1a
Early, TX 76802-2209 - Phone
- (325) 646-9900
- Fax
- (325) 646-9100
- NPI assigned
- May 11, 2017
- Organization subpart
- No
Authorized official
- Name
- Mr. Scott David King, MPT
- Title
- Manager
- Phone
- (325) 200-8641
Practitioners 1
-
Scott David King, PT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20170605000964 | TX | Part B Supplier - Clinic/Group Practice | 7315214863 |
Receives reassigned benefits from 1 practitioner Practice locations: Early, TX |
National Provider Directory
Locations
919 Early Blvd
Ste 1A
Early, TX 76802
Phone (325) 646-5565
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | 1120111 | TX | Yes |
Addresses
Primary practice location
919 Early Blvd
Suite 1a
Early, TX 76802-2209
Mailing address
919 Early Blvd
Suite 1a
Early, TX 76802-2209
Phone (325) 646-9900
Other names
- Action Physical Therapy and Wellness
Other providers in Early, TX
- Affinity Distribution, Inc
- Landry Alexander
- Randall M Barron
- Patrick Ryan Bell
- Angelique Lavonne Bishop
All providers in Early, TX · Physical Therapy Clinic/Center in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 11, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.