Southwest Sports & Spine, LLP

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

635850000 Issued in TX

Legal business name

SOUTHWEST SPORTS & SPINE, LLP

Doing business as

Vista Physical Therapy

Practice address

11661 Preston Rd
Suite 173
Dallas, TX 75230-2745

Phone

(214) 265-7200

Fax

(214) 265-7521

NPI assigned

Oct 4, 2005

Last updated

Apr 14, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Craig RettkeNPI 1831434125

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

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Craig Rettke, PT

  • Physical Therapist
  • McKinney, TX
  • NPI 1831434125
  Authorized official Same address or phone

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": "1760479760",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11661 PRESTON RD",
            "address_2": "SUITE 173",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302745",
            "telephone_number": "214-265-7200",
            "fax_number": "214-265-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11661 PRESTON RD",
            "address_2": "SUITE 173",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302745",
            "telephone_number": "214-265-7200",
            "fax_number": "214-265-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST SPORTS & SPINE, 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": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "635850000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0033EL",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vista Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southwest Podiatry, LLP
• Southwest Podiatry, LLP
• Southwest Professional Surgical Associates
• Southwest Pulmonary Associates
• Southwest Sports & Spine V, LLP (Vista Physical Therapy)
• Southwest Surgical Oncology Associates
• Southwest Urology Associates
• Southwest Vascular and Surgical Group (Dallas Surgical Group)
• Southwestern Pain Institute, PA
• Southwestern Women's Surgery Center

• Physical Therapist in Dallas, TX
• Providers in Dallas, 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.