| Obach Physical Therapy Clinic Llc | |
|
200 County Road 3801, Bullard, TX 75757 | |
| (903) 894-4633 | |
| (903) 894-4648 |
| Full Name | Obach Physical Therapy Clinic Llc |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 200 County Road 3801, Bullard, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912398348 | NPI | - | NPPES |
| 1059236 | Other | TX | LICENSE NO. |
| 1063700110 | Other | TX | NPI |
| TXB134151 | Other | TX | MEDICARE NO. |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 1059236 (Texas) | Primary |
| Provider Name | Ralph R Obach |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1063700110 PECOS PAC ID: 1850562745 Enrollment ID: I20110926000759 |
| Provider Name | Penny L Patterson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760746184 PECOS PAC ID: 9739338369 Enrollment ID: I20120925000723 |
| Provider Name | Kevin Ryan Ridad |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629658893 PECOS PAC ID: 6406254325 Enrollment ID: I20211007000926 |
| Provider Name | Patrick Michael Cook |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1427651512 PECOS PAC ID: 7618365933 Enrollment ID: I20211019001588 |
| Mailing Address | Practice Location Address |
|---|---|
| Obach Physical Therapy Clinic Llc 4882 Hightech Dr, Tyler, TX 75703-2613 Ph: (903) 300-0234 | Obach Physical Therapy Clinic Llc 200 County Road 3801, Bullard, TX 75757 Ph: (903) 894-4633 |
Ralph Rosauro Mendoza Obach, LPT Physical Therapist Medicare: May Accept Medicare Assignments Practice Location: 200 County Rd 3801, Bullard, TX 75757 Phone: 903-894-4633 Fax: 903-463-4648 | |
Micaela Mcsheffery Lewis, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 200 County Road 3801, Bullard, TX 75757 Phone: 903-243-0421 |