Organization
BUNKER & EILAND PC
Active
Other names
Physical Therapy Services
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN D CHILDS PT SCS (CEO)
(888) 590-4002
Entity
Organization
Contact information
Practice address
5407 NEW COPELAND RD, TYLER, TX 75703-3951
(903) 597-3386
(903) 531-2241
Mailing address
5407 NEW COPELAND RD, TYLER, TX 75703-3951
(903) 597-3386
(903) 531-2241
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
602160000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021694701
MEDICAID
TX
05
—
080550901
—
TX
01
—
84381T
BCBS OF TX
TX
01
—
84382T
BCBS OF TX
TX
Enumeration date
03/27/2006
Last updated
11/09/2010
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