Bowie Physical Therapy & Sports Medicine PC
Organization Active NPI Physical Therapist · Bowie, TX
NPI 1639128481 · NPPES record last updated May 20, 2009
Key facts
- NPI
- 1639128481
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- 1008498 (TX)
- Legal business name
- BOWIE PHYSICAL THERAPY & SPORTS MEDICINE PC
- Practice address
- 1111 E Wise St
Bowie, TX 76230-4516 - Phone
- (940) 872-6852
- Fax
- (940) 872-6859
- NPI assigned
- May 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Danny Baxter Laws, LPT
- Title
- Owner Director of PT
- Phone
- (940) 872-6852
Practitioners 1
-
Danny Baxter Laws, L.P.T
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110407000204 | TX | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 7012073281 |
Receives reassigned benefits from 1 practitioner Practice locations: Bowie, TX |
National Provider Directory
Locations
1111 E Wise St
Bowie, TX 76230
Phone (940) 872-6852
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 1008498 | TX | Yes |
Addresses
Primary practice location
1111 E Wise St
Bowie, TX 76230-4516
Mailing address
1111 E Wise St
Bowie, TX 76230-4516
Phone (940) 872-6852
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8T2662 | Other | TX | BLUE CROSS BLUE SHEILD |
| 0029LJ | Other | TX | BC BS GROUP |
| 1079816-01 | Medicaid | TX | |
| 686183 | Other | TX | ACN GROUP |
Other names
- Bowie Physical Therapy & Sports Medicine
Other providers in Bowie, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 20, 2009. 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.