1861880312 NPI number — MOMENTUM PHYSICAL & SPORTS REHABILITATION LIMITED PARTNERSHIP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861880312 NPI number — MOMENTUM PHYSICAL & SPORTS REHABILITATION LIMITED PARTNERSHIP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOMENTUM PHYSICAL & SPORTS REHABILITATION LIMITED PARTNERSHIP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861880312
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12952 BANDERA RD STE 107
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HELOTES
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78023-4733
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-372-9600
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7003 S NEW BRAUNFELS AVE
Provider Second Line Business Practice Location Address:
SUITE 114
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78223-4588
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-892-0359
Provider Business Practice Location Address Fax Number:
210-253-9535
Provider Enumeration Date:
01/07/2015

Additional Information

Authorized Official

Authorized Official Last Name:
BINSTEIN
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
Authorized Official Title or Position:
VP, AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
713-297-7000

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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