Comal Physical Medicine and Rehabilitation PLLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

Q4035 Issued in TX

Legal business name

COMAL PHYSICAL MEDICINE AND REHABILITATION PLLC

Practice address

2041 Sundance Pkwy
New Braunfels, TX 78130-2779

Phone

(830) 625-6700

NPI assigned

Jul 13, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Justin Frederick Black, D.O.NPI 1982903290

Title

Organizer

Phone

(817) 653-0788

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

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

• Justin Frederick Black, D.O.

  • Physical Medicine & Rehabilitation Physician
  • New Braunfels, TX
  • NPI 1982903290
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624233600000",
    "number": "1356725964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 MAIN PLZ # 170",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781305136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 SUNDANCE PKWY",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781302779",
            "telephone_number": "830-625-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMAL PHYSICAL MEDICINE AND REHABILITATION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2021-06-21",
        "certification_date": "2021-06-21",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "ORGANIZER",
        "authorized_official_telephone_number": "817-653-0788",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "Q4035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Comal Isd
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• Comal Springs Community Acupuncture, PLLC
• Peyton D Cometti, D.D.S.
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• Comprehensive Health Services
• Concentra Primary Care PA

• Physical Medicine & Rehabilitation Physician in New Braunfels, TX
• Providers in New Braunfels, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.