Provider Demographics
NPI:1588774897
Name:REHAB CONSULTANTS INC
Entity type:Organization
Organization Name:REHAB CONSULTANTS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:LARSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPT
Authorized Official - Phone:817-923-1800
Mailing Address - Street 1:1617 PARK PLACE AVE
Mailing Address - Street 2:STE 110
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76110-1300
Mailing Address - Country:US
Mailing Address - Phone:817-923-1800
Mailing Address - Fax:817-923-2059
Practice Address - Street 1:1617 PARK PLACE AVE
Practice Address - Street 2:STE 110
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76110-1300
Practice Address - Country:US
Practice Address - Phone:817-923-1800
Practice Address - Fax:817-923-2059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1043453225100000X
TX1065415225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
86336TOtherBCBS