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Organization
FEDERAL ROAD REHAB & DIAGNOSTIC INC
Active
Organization
FEDERAL ROAD REHAB & DIAGNOSTIC INC
Active
Other names
NORTHSHORE AQUATHERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM J KOWALSKI DC (OWNER)
(713) 451-1400
Entity
Organization
Contact information
Practice address
12655 WOODFOREST BLVD STE 100, HOUSTON, TX 77015-3575
(713) 455-2535
(713) 451-1411
Mailing address
12655 WOODFOREST BLVD, SUITE #100, HOUSTON, TX 77015-3564
(713) 455-2535
(713) 451-1411
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
2889
TX
225100000X
Physical Therapist
Primary
1013647
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0091KK
BC/ BS GRP #
TX
05
—
045155001
—
TX
01
—
328188800
DOL
TX
01
—
350017778
RAILROAD MEDICARE
TX
01
—
CS4064
MEDICARE RAILROAD
TX
Enumeration date
02/27/2007
Last updated
07/22/2013
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