Basic Information
| Provider Information | |||||||||
| NPI: | 1689399156 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | AGILITAS USA, INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 306393 | ||||||||
| Address2: | |||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372306393 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153731350 | ||||||||
| FaxNumber: | 6153737116 | ||||||||
| Practice Location | |||||||||
| Address1: | 6845 PEEK RD STE 150 | ||||||||
| Address2: | |||||||||
| City: | KATY | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77493 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3462912799 | ||||||||
| FaxNumber: | 8328714262 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/07/2022 | ||||||||
| LastUpdateDate: | 10/07/2022 | ||||||||
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| AuthorizedOfficialLastName: | BARGANIER | ||||||||
| AuthorizedOfficialFirstName: | THOMAS BRYAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 2055367602 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | AGILITAS USA, INC | ||||||||
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| NPICertificationDate: | 10/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.