Tribe Wellness, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1286327 Issued in TX

Legal business name

TRIBE WELLNESS, LLC

Practice address

100 N Cottonwood Dr Ste 108
Richardson, TX 75080-4772

Phone

(214) 702-6559

Fax

(469) 779-1064

NPI assigned

Jan 2, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Michael C Braitsch, PT, DPT

Title

Lead Therapist

Phone

(214) 702-6559

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1514851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607472000000",
    "number": "1770090516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N COTTONWOOD DR STE 108",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750804772",
            "telephone_number": "214-702-6559",
            "fax_number": "469-779-1064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N COTTONWOOD DR STE 108",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750804772",
            "telephone_number": "214-702-6559",
            "fax_number": "469-779-1064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIBE WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-02",
        "last_updated": "2020-12-09",
        "certification_date": "2020-12-09",
        "status": "A",
        "authorized_official_last_name": "BRAITSCH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "LEAD THERAPIST",
        "authorized_official_telephone_number": "214-702-6559",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "1286327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Richardson, TX
• Providers in Richardson, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.