Organization
PERFORMANCEPRO SPORTS MEDICINE AND REHABILITATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANNA KING JD (VP, AUTHORIZED OFFICIAL)
(713) 297-7000
Entity
Organization
Contact information
Practice address
4135 S BROADWAY AVE, TYLER, TX 75701-8720
(903) 581-8662
(903) 581-7808
Mailing address
4135 S BROADWAY AVE, TYLER, TX 75701-8720
(903) 581-8662
(903) 581-7808
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
10/07/2008
Last updated
03/03/2020
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