Fayco Sport & Spine PLLC
Organization Active NPI Physical Therapist · Flatonia, TX
NPI 1306535448 · NPPES record last updated Jan 3, 2024
Key facts
- NPI
- 1306535448
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- Legal business name
- FAYCO SPORT & SPINE PLLC
- Practice address
- 109 E North Main St
Flatonia, TX 78941-2239 - Phone
- (830) 613-6008
- NPI assigned
- May 4, 2023
- Organization subpart
- No
Authorized official
- Name
- Aaron James Gray, PT, DPT
- Title
- Owner/Employee
- Phone
- (830) 613-6008
Practitioners 1
-
Aaron Gray, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230712002661 | TX | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 0446610299 |
Receives reassigned benefits from 1 practitioner Practice locations: Flatonia, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes |
Addresses
Primary practice location
109 E North Main St
Flatonia, TX 78941-2239
Mailing address
PO Box 374
Flatonia, TX 78941-0374
Phone (830) 613-6008
Other names
- FayCo Sport & Spine
Other providers in Flatonia, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2024. 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.