Organization
REVIVE PHYSICAL THERAPY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY JANE PLATT RPT (PRESIDENT)
(512) 264-9981
Entity
Organization
Contact information
Practice address
21122 STATE HIGHWAY 71 W, UNIT B, SPICEWOOD, TX 78669-6120
(512) 264-9981
(512) 264-9978
Mailing address
21122 STATE HIGHWAY 71 W, UNIT B, SPICEWOOD, TX 78669-6120
(512) 264-9981
(512) 264-9978
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
1105518
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0011KM
BCBS TX
TX
Enumeration date
06/17/2005
Last updated
08/22/2020
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