Organization
CORNERSTONE PHYSICAL MEDICINE & REHABILITATION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM THREADGILL PHYSICAL THERAPIST (OWNER)
(806) 783-8234
Entity
Organization
Contact information
Practice address
4010 82ND ST, SUITE 130, LUBBOCK, TX 79423-1949
(806) 783-8234
(806) 783-8235
Mailing address
5907 84TH ST, LUBBOCK, TX 79424-3609
(806) 783-8234
(806) 783-8235
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0046ME
BLUECROSSBLUESHIELD GROUP
TX
Enumeration date
12/19/2006
Last updated
08/22/2020
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