Organization
XTREME MEDICAL REHAB
Active
Other names
DFW Medical Pain & Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JASON WANDER D.O. (PRESIDENT)
(817) 656-1615
Entity
Organization
Contact information
Practice address
1710 RUFE SNOW DR, 120, KELLER, TX 76248-5745
(817) 656-1615
(817) 428-0573
Mailing address
1710 RUFE SNOW DR, 120, KELLER, TX 76248-5745
(817) 656-1615
(817) 428-0573
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
N6762
TX
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
N6762
TX
Other
Enumeration date
12/21/2016
Last updated
12/21/2016
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