Physiatry Service Organization, Inc.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

PHYSIATRY SERVICE ORGANIZATION, INC.

Practice address

103 N 1St St
Rockwall, TX 75087-3033

Phone

(214) 403-3959

Fax

(817) 284-3505

NPI assigned

Jan 24, 2007

Organization subpart

No

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

Authorized official

Name

Gwen A. Fields, M.D.

Title

Secretary

Phone

(214) 403-3959

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376698944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678413",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678413",
            "telephone_number": "214-403-3959",
            "fax_number": "817-284-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 N 1ST ST",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750873033",
            "telephone_number": "214-403-3959",
            "fax_number": "817-284-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIATRY SERVICE ORGANIZATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "GWEN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "214-403-3959",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benie Cam-Hang Pham, DO
• Stan Mepurath Philip, PA-C
• Elizabeth Phillips, FNP-C
• Kara Jade Phillips
• Chynna Phung
• Physical Therapy Today of Lubbock LP
• Glynn John Pickens, MD
• Janette L Pickens, DPT
• Daneane Pierce, RPT
• Emily Pierce, DPT

• Physical Medicine & Rehabilitation Physician in Rockwall, TX
• Providers in Rockwall, 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 Aug 22, 2020; 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.