# IDEAL PHYSICAL THERAPY OF TEXAS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922756188
- **Authorized official:** KATIE WATKINS (DIRECTOR OF CREDENTIALING)
- **Authorized official phone:** (630) 296-2222

## Contact information

- **Practice address:** 2606 W PECAN ST \# 102, PFLUGERVILLE, TX 78660-1917
- **Practice address phone:** (512) 527-6298
- **Practice address fax:** (512) 548-4093
- **Mailing address:** 790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 03/16/2022
- **Last updated:** 03/16/2022