Provider Demographics
NPI:1528606357
Name:ESMPT, LLC
Entity type:Organization
Organization Name:ESMPT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:WISE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-732-5981
Mailing Address - Street 1:8810 WOODWAY DR STE 306
Mailing Address - Street 2:
Mailing Address - City:WOODWAY
Mailing Address - State:TX
Mailing Address - Zip Code:76712-3653
Mailing Address - Country:US
Mailing Address - Phone:254-732-5981
Mailing Address - Fax:254-754-2667
Practice Address - Street 1:8810 WOODWAY DR STE 306
Practice Address - Street 2:
Practice Address - City:WOODWAY
Practice Address - State:TX
Practice Address - Zip Code:76712-3653
Practice Address - Country:US
Practice Address - Phone:254-325-9817
Practice Address - Fax:254-754-2667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-11
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPENDINGMedicaid