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Organization
FUNCTIONAL REHABILITATION PEDIATRICS, PLLC
Active
Organization
FUNCTIONAL REHABILITATION PEDIATRICS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRANDA SHEA WILLIAMS DPT (OWNER)
(936) 591-4281
Entity
Organization
Contact information
Practice address
169 COUNTY ROAD 1037, CENTER, TX 75935-7936
(936) 591-4281
Mailing address
169 COUNTY ROAD 1037, CENTER, TX 75935-7936
(936) 591-4281
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1187778
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1187778
LICENSE
TX
Enumeration date
12/30/2016
Last updated
12/30/2016
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