Provider Demographics
NPI:1972523447
Name:COPPELL SPINE & SPORTS REHAB LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:COPPELL SPINE & SPORTS REHAB LIMITED PARTNERSHIP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:8700 N TARRANT PKWY
Mailing Address - Street 2:SUITE 113
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-8464
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8700 N TARRANT PKWY
Practice Address - Street 2:SUITE 113
Practice Address - City:N RICHLND HLS
Practice Address - State:TX
Practice Address - Zip Code:76182-8464
Practice Address - Country:US
Practice Address - Phone:817-498-8344
Practice Address - Fax:817-498-8702
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COPPELL SPINE & SPORTS REHAB LIMITED PARTNERSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-20
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX456844Medicare Oscar/Certification