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Organization

EXCEL SPINE AND SPORTS REHAB PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
RANDY VILLARD PT (CEO/ PRESIDENT)
(469) 865-7297
Entity
Organization

Contact information

Practice address
3901 MAIN ST STE 10, ROWLETT, TX 75088-5171
(469) 443-0458
(469) 573-6918
Mailing address
3901 MAIN ST STE 10, ROWLETT, TX 75088-5171
(469) 443-0458
(469) 573-6918

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1124683
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1457461915
NATIONAL PROVIDER IDENTIFIER
TX
05
576151
TX
Enumeration date
11/23/2016
Last updated
07/30/2025
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