Basic Information
Provider Information | |||||||||
NPI: | 1720515844 | ||||||||
EntityType: | 2 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: | RELEVE REHABILITATION PLLC | ||||||||
LastName: |   | ||||||||
FirstName: |   | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: |   | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 990 HIGHWAY 287 N STE 106-268 | ||||||||
Address2: |   | ||||||||
City: | MANSFIELD | ||||||||
State: | TX | ||||||||
PostalCode: | 760632607 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9724281600 | ||||||||
FaxNumber: | 8887706360 | ||||||||
Practice Location | |||||||||
Address1: | 2301 MARSH LN | ||||||||
Address2: |   | ||||||||
City: | PLANO | ||||||||
State: | TX | ||||||||
PostalCode: | 750938497 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9724281600 | ||||||||
FaxNumber: | 8887706360 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/19/2017 | ||||||||
LastUpdateDate: | 05/19/2017 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: |   | ||||||||
AuthorizedOfficialLastName: | SHAIKH | ||||||||
AuthorizedOfficialFirstName: | ADNAN | ||||||||
AuthorizedOfficialMiddleName: | ANWAR | ||||||||
AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
AuthorizedOfficialTelephone: | 2144156845 | ||||||||
IsSoleProprietor: |   | ||||||||
IsOrganizationSubpart: | N | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | N0989 | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |   |
ID Information
ID | Type | State | Issuer | Description | N0989 | 01 | TX | N0989 | OTHER |