Vista Rehabilitation of Mesquite, LLP

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

656520000 Issued in TX

Legal business name

VISTA REHABILITATION OF MESQUITE, LLP

Doing business as

Vista Physical Therapy

Practice address

2758 N Galloway Ave
Suite 100
Mesquite, TX 75150-6380

Phone

(972) 681-1155

Fax

(972) 681-3575

NPI assigned

Oct 4, 2005

Organization subpart

No

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

Authorized official

Name

Craig Rettke

Title

Partner

Phone

(972) 529-3691

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Vista Physical Therapy Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Vista Rehab Partners, LP

  dba Vista Physical Therapy

  • Physical Therapist
  • Haltom City, TX
  • NPI 1831435437

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649894400000",
    "number": "1447247465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2758 N GALLOWAY AVE",
            "address_2": "SUITE 100",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506380",
            "telephone_number": "972-681-1155",
            "fax_number": "972-681-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2758 N GALLOWAY AVE",
            "address_2": "SUITE 100",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751506380",
            "telephone_number": "972-681-1155",
            "fax_number": "972-681-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA REHABILITATION OF MESQUITE, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A",
        "authorized_official_last_name": "RETTKE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "972-529-3691"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "656520000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0022JB",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapist in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.