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Organization

PARADIGM PHYSICAL THERAPY & SPORTS SCIENCE CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. WILLIAM H DODSON PT, DSC, OCS, CHT (PHYSICAL THERAPIST,OWNER)
(432) 580-3300
Entity
Organization

Contact information

Practice address
701 N GRANT AVE, ODESSA, TX 79761-4504
(432) 580-3300
(432) 580-0505
Mailing address
701 N GRANT AVE, ODESSA, TX 79761-4504
(432) 580-3300
(432) 580-0505

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1072692
TX
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
613030000
TX
332B00000X
Durable Medical Equipment & Medical Supplies
0039729
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0060DL
BCBS
TX
01
021716801
MEDICAID (SECONDARY)
TX
01
062884401
MEDICAID (PRIMARY)
TX
01
144906801
MEDICAID DME
TX
01
144906802
MEDICAID DME
TX
01
456783
MEDICARE
TX
Enumeration date
03/26/2007
Last updated
07/15/2015
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