# PHYSIOTHERAPY ASC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MATRIX NORTH DALLAS PT
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154662468
- **Authorized official:** TAMARA KAMPHAUS PT (FACILITY DIRECTOR)
- **Authorized official phone:** (972) 437-2048

## Contact information

- **Practice address:** 510 N COIT RD, 2035 PROMENADE CTR, RICHARDSON, TX 75080-5446
- **Practice address phone:** (972) 437-2048
- **Practice address fax:** (972) 480-8514
- **Mailing address:** 510 N COIT RD, 2035 PROMENADE CTR, RICHARDSON, TX 75080-5446
- **Mailing address phone:** (972) 437-2048
- **Mailing address fax:** (972) 480-8514

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | 112244 | TX | Yes |

## Other

- **Enumeration date:** 03/12/2013
- **Last updated:** 03/12/2013