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Organization
MPFK, INC.
Active
Organization
MPFK, INC.
Active
Other names
DYNAMIC CARE REHAB
Organization subpart
No
Provider details
NPI number
Authorized official
MARK JEROME V. GONZALES PT (PRESIDENT/ PT IN CHARGE)
(915) 408-0699
Entity
Organization
Contact information
Practice address
1401 MONTANA AVE, SUITE D, EL PASO, TX 79902-5673
(915) 408-0699
(915) 503-2297
Mailing address
1401 MONTANA AVE, SUITE D, EL PASO, TX 79902-5673
(915) 408-0699
(915) 503-2297
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1123313
TX
225X00000X
Occupational Therapist
111483
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
293994
MEDICARE
TX
Enumeration date
02/26/2013
Last updated
04/07/2016
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