Texas Physical Medicine and Rehabilitation Center, Inc.

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

License

F005818 Issued in TX

Legal business name

TEXAS PHYSICAL MEDICINE AND REHABILITATION CENTER, INC.

Practice address

4915 Gus Thomasson Rd
Mesquite, TX 75150-1061

Phone

(214) 319-0006

Fax

(214) 319-9889

NPI assigned

May 21, 2008

Organization subpart

No

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

Authorized official

Name

Christopher Edomwande

Title

President / Ceo

Phone

(214) 319-0006

Specialties & licenses 1

Addresses

Other names 1

• The Health Center at Laprada Doing business as

Locations

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211328000000",
    "number": "1306003983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4915 GUS THOMASSON RD",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751501061",
            "telephone_number": "214-319-0006",
            "fax_number": "214-319-9889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4915 GUS THOMASSON RD",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751501061",
            "telephone_number": "214-319-0006",
            "fax_number": "214-319-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS PHYSICAL MEDICINE AND REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A",
        "authorized_official_last_name": "EDOMWANDE",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "214-319-0006"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "TX",
            "license": "F005818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Health Center at Laprada",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Health Service Clinic/Center in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Health Service Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.