Organization
EAST REHABILITATION PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN W EAST DO (PRESIDENT)
(972) 380-0000
Entity
Organization
Contact information
Practice address
16633 DALLAS PKWY STE 150, ADDISON, TX 75001-6812
(972) 380-0000
(972) 380-0030
Mailing address
16633 DALLAS PKWY STE 150, ADDISON, TX 75001-6812
(972) 380-0000
(972) 380-0030
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207Q00000X
Family Medicine Physician
M1138
TX
207R00000X
Internal Medicine Physician
P8718
TX
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154668101
—
TX
Enumeration date
03/28/2006
Last updated
07/21/2022
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