SPORTHERAPY SOUTHWEST PC NPI 1801812698

NPI Information

NPI: 1801812698
Provider Name: SPORTHERAPY SOUTHWEST, PC
Classification: Clinic/Center - 261QR0401X
Entity Type: Organization

Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

Address:
6037 HARRIS PKWY
FORT WORTH, TX
ZIP 76132
Phone: (817) 370-9891
Get Directions

SPORTHERAPY SOUTHWEST, PC is a rehabilitation and comprehensive outpatient rehabilitation facility (corf) clinic center in Fort Worth, TX. SPORTHERAPY SOUTHWEST, PC NPI is 1801812698. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

6037 HARRIS PKWY
FORT WORTH, TX
ZIP 76132-103
Phone: (817) 370-9891
Fax: (817) 370-9894

The provider's authorized official is Steven B Lackey .
The authorized official title is Business Director and has the following contact phone number (817) 370-9891.

The enumeration date for this NPI number is 7/14/2006 and was last updated on 5/20/2014.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	225100000X	Physical Therapist		605100000	TEXAS	No
2	261QR0400X	Clinic/Center	Rehabilitation	605100000	TEXAS	No
3	261QR0401X	Clinic/Center	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	605100000	TEXAS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	45-6752	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	MEDICARE FACILITY

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: 11/14/2023

NPI Synchronization or Removal

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