Provider Demographics
NPI:1043332158
Name:PLANO PHYSICAL MEDICINE & REHAB
Entity type:Organization
Organization Name:PLANO PHYSICAL MEDICINE & REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:D
Authorized Official - Last Name:ZUBER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-733-0915
Mailing Address - Street 1:PO BOX 1418
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-1418
Mailing Address - Country:US
Mailing Address - Phone:972-733-0915
Mailing Address - Fax:972-265-8110
Practice Address - Street 1:4708 W PLANO PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-5333
Practice Address - Country:US
Practice Address - Phone:972-733-0915
Practice Address - Fax:972-265-8110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0097KZOtherBCBS OF TX
TX00505XMedicare PIN