Provider Demographics
NPI:1396627378
Name:KINGDOM RECOVERY AND INJURY
Entity type:Organization
Organization Name:KINGDOM RECOVERY AND INJURY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:214-810-4124
Mailing Address - Street 1:342 ASH BROOK LN
Mailing Address - Street 2:
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-3251
Mailing Address - Country:US
Mailing Address - Phone:214-803-0768
Mailing Address - Fax:
Practice Address - Street 1:10550 PLANO RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75238-1306
Practice Address - Country:US
Practice Address - Phone:214-810-4124
Practice Address - Fax:214-387-1232
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational MedicineGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation