Organization
PEDIATRIC REHABILITATION OF TEXAS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY KENT WILSON BSPT (PHYSICAL THERAPIST)
(409) 833-4115
Entity
Organization
Contact information
Practice address
3195 CALDER ST, STE 201, BEAUMONT, TX 77702-1425
(409) 833-4115
(409) 833-1626
Mailing address
3195 CALDER ST, STE 201, BEAUMONT, TX 77702-1425
(409) 833-4115
(409) 833-1626
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1012458
TX
Other
Enumeration date
06/14/2012
Last updated
06/14/2012
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