NPIMap

Organization Active NPI

Premier Rehab Physical Therapy

  • Physical Therapy Clinic/Center
  • Keller, TX
National Provider Identifier
1558739342
Registry record updated Sep 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
1263891 Issued in TX
Legal business name
PREMIER REHAB PHYSICAL THERAPY
Practice address
4120 Heritage Trace Pkwy Ste 220
Keller, TX 76248
Phone
(817) 741-7585
NPI assigned
Sep 10, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2015

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

Authorized official

Name
Maria Underwood
Title
Adminstrator
Phone
(817) 200-7445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 1263891 TX Primary

Addresses

Primary practice location

4120 Heritage Trace Pkwy Ste 220
Keller, TX 76248

Mailing address

4120 Heritage Trace Pkwy Ste 220
Keller, TX 76248
Phone (817) 741-7585

National Provider Directory

National Provider Directory
Tax ID family
Premier Rehab Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1441843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441843200000",
    "number": "1558739342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4120 HERITAGE TRACE PKWY STE 220",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76248",
            "telephone_number": "817-741-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 HERITAGE TRACE PKWY STE 220",
            "city": "KELLER",
            "state": "TX",
            "postal_code": "76248",
            "telephone_number": "817-741-7585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER REHAB PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-10",
        "last_updated": "2015-09-10",
        "status": "A",
        "authorized_official_last_name": "UNDERWOOD",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "ADMINSTRATOR",
        "authorized_official_telephone_number": "817-200-7445"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "1263891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keller, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; 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.