| Rockwall Physical Medicine Pllc | |
|
1141 Ridge Rd Ste A Rockwall TX 75087-4217 | |
| (972) 771-9844 | |
| (972) 771-4674 |
| Full Name | Rockwall Physical Medicine Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 1141 Ridge Rd Ste A, Rockwall, Texas |
| Authorized Official Name and Position | Timothy David Payne (OWNER) |
| Authorized Official Contact | 9032686965 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rockwall Physical Medicine Pllc Po Box 2526 Rockwall TX 75087-9026 Ph: (903) 268-6965 | Rockwall Physical Medicine Pllc 1141 Ridge Rd Ste A Rockwall TX 75087-4217 Ph: (972) 771-9844 |
| NPI Number | 1700531050 |
|---|---|
| Provider Enumeration Date | 02/15/2022 |
| Last Update Date | 09/23/2022 |
| Medicare PECOS PAC ID | 3375910664 |
|---|---|
| Medicare Enrollment ID | O20221101000507 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700531050 | NPI | - | NPPES |
| 10933 | Other | TX | TBCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Timothy David Payne |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1962668723 PECOS PAC ID: 0446532378 Enrollment ID: I20170128000138 |
| Provider Name | Christopher Cummings |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1194244533 PECOS PAC ID: 0446517692 Enrollment ID: I20171127002229 |
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