Provider Demographics
NPI:1154154433
Name:BONE-A-FIDE PHYSIO & PERFORMANCE LLC
Entity type:Organization
Organization Name:BONE-A-FIDE PHYSIO & PERFORMANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANIBAL
Authorized Official - Middle Name:NEFTALI
Authorized Official - Last Name:RAMIREZ-BARRIOS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:469-237-9282
Mailing Address - Street 1:2380 S MACGREGOR WAY APT 224
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-1171
Mailing Address - Country:US
Mailing Address - Phone:469-237-9282
Mailing Address - Fax:
Practice Address - Street 1:2380 S MACGREGOR WAY APT 224
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-1171
Practice Address - Country:US
Practice Address - Phone:469-237-9282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty