Organization
THE RANCH SPORTS MEDICINE AND REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES BELL STEPHENSON II P.T. (PRESIDENT)
(972) 401-4774
Entity
Organization
Contact information
Practice address
10010 N MACARTHUR BLVD, IRVING, TX 75063-5001
(972) 401-4774
(972) 401-0800
Mailing address
10010 N MACARTHUR BLVD, IRVING, TX 75063-5001
(972) 401-4774
(972) 401-0800
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1061596
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82672T
BCBS PROVIDER #
TX
Enumeration date
01/09/2007
Last updated
08/22/2020
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