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Organization

CENTRE OF PHYSICAL REHABILITATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PROF. SERGE BRUNO SAITHSOOTHANE P.T. (CLINIC DIRECTOR AND OWNER)
(972) 599-9191
Entity
Organization

Contact information

Practice address
2301 COIT RD, SUITE B, PLANO, TX 75075-3773
(972) 599-9191
(972) 599-2323
Mailing address
2301 COIT RD, SUITE B, PLANO, TX 75075-3773
(972) 599-9191
(972) 599-2323

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
155903
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000093JN
BCBS GROUP PROVIDER ID
TX
01
0027019
BLUE LINK NUMBER
TX
01
8T0895
BCBS PROVIDER ID
TX
Enumeration date
11/08/2005
Last updated
08/22/2020
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