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is a Clinic/center - Physical Therapy based in Southlake, Texas. is licensed to practice in * (Not Available) (license number ) and their current practice location is 1959 W Southlake Blvd Ste 180, Southlake, Texas. It can be reached at their office (for appointments etc.) via phone at (330) 423-3115.

NPI number for is 1366260937 and their current mailing address is 3901 Stedman Trl, Fort Worth, Texas. does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1366260937.

Contact Information

1959 W Southlake Blvd Ste 180,
Southlake, TX 76092-0305
(330) 423-3115
Not Available

Map and Direction




Healthcare Provider's Profile

Full Name
TypeFacility
SpecialityClinic/center - Physical Therapy
Location1959 W Southlake Blvd Ste 180, Southlake, Texas
Accepts Medicare AssignmentsDoes not participate in Medicare Program. The facility may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1366260937
  • Provider Enumeration Date: 10/01/2024
  • Last Update Date: 01/09/2025

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1366260937NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist (* (Not Available))Secondary
261QP2000XClinic/center - Physical Therapy (* (Not Available))Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address

3901 Stedman Trl,
Fort Worth, TX 76244-6057

Ph: () -
1959 W Southlake Blvd Ste 180,
Southlake, TX 76092-0305

Ph: (330) 423-3115

Reviews and Comments



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Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

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