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BACKTOGOLF PERFORMANCE CENTER LLC NPI 1922202126


NPI Information

NPI: 1922202126
Provider Name: BACKTOGOLF PERFORMANCE CENTER, LLC
Classification: Physical Therapist - 2251S0007X
Entity Type: Organization

Specialization: Sports

Address:
7401 STATE HIGHWAY 45
AUSTIN, TX
ZIP 78739
Phone: (512) 371-7687
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BACKTOGOLF PERFORMANCE CENTER, LLC is a sports physical therapist in Austin, TX. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, pathology and pathophysiology, medical and surgical intervention, and health and wellness, as well as rehabilitation/return to sports, management of acute injury/illness, medical and surgical consideration, injury prevention, and sports performance enhancement. BACKTOGOLF PERFORMANCE CENTER, LLC NPI is 1922202126. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

7401 STATE HIGHWAY 45
AUSTIN, TX
ZIP 78739-901
Phone: (512) 371-7687
Fax: (512) 371-7601

The provider's authorized official is M. Jay Platt .
The authorized official title is President and has the following contact phone number (512) 371-7687.

The enumeration date for this NPI number is 6/12/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12251S0007XPhysical TherapistSports1029148TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10089GJOTHERTEXASBCBS GROUP NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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