Organization
ACTIVE REHABILITATION,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SCOTT CALDWELL MED. (PRESIDENT)
(972) 964-6633
Entity
Organization
Contact information
Practice address
1200 COIT RD, SUITE 101A, PLANO, TX 75075-4750
(972) 964-6633
Mailing address
PO BOX 261441, PLANO, TX 75026-1441
(972) 964-6633
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0002DZ
BLUECROSS
TX
01
—
0078383
BLUELINK NUMBER
TX
01
—
5109303
AETNA,PPO,POS,EPO
TX
Enumeration date
08/04/2006
Last updated
08/22/2020
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