| |
2363 Highway 287 N Ste 205, Mansfield, TX 76063-7587 | |
(817) 592-3021 | |
(888) 557-1669 |
Full Name | |
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Type | Facility |
Speciality | Rehabilitation Practitioner |
Location | 2363 Highway 287 N Ste 205, Mansfield, Texas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1609246529 | NPI | - | NPPES |
4121493-01 | Medicaid | TX |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Secondary |
225400000X | Rehabilitation Practitioner | (* (Not Available)) | Primary |
Provider Name | Chester Ray Rhines |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1740317924 PECOS PAC ID: 9638460736 Enrollment ID: I20160621001378 |
Mailing Address | Practice Location Address |
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4204 Stonebriar Trl, Mansfield, TX 76063-5875 Ph: (817) 592-3021 | 2363 Highway 287 N Ste 205, Mansfield, TX 76063-7587 Ph: (817) 592-3021 |