WILCO THERANET, LLC (NPI# 1679667695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679667695 |
| Entity Type | Organization |
| Organization Name | WILCO THERANET, LLC |
| Other Organization Name | PHYSICAL THERAPY ASSOCIATES |
| Practice Address |
127 Medical Park Ln Huntsville TX 77340-4972 |
| Practice Telephone | 9362940283 |
| Practice Fax Number | 9362949878 |
| Mailing Telephone | 9362940283 |
| Mailing Fax Number | 9362949878 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-08-20 |
| Authorized Official Name | DALLAS C WILLIAMS (PT DIRECTOR / OWNER) |
| Authorized Official Telephone | 9362940283 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 640210000 | TX | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS PROVIDER NUMBER | 85643T | 01 |
| TX | 152359901 | 05 |
| Other Name | Type Code |
|---|---|
| Physical Therapy Associates | Doing Business As Name - Organization |
| Street Address |
127 MEDICAL PARK LN |
| City | HUNTSVILLE |
| State | TX |
| Zip Code | 77340-4972 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790788362 | Walter L Stowe | Specialist | 127 Medical Park Ln, Huntsville, TX 77340-4972 | 2005-05-27 |
| 1477986735 | Jill Huber | Physical Therapy Assistant | 127 Medical Park Ln, Huntsville, TX 77340-4972 | 2013-08-09 |
| 1518399971 | Richard Nicholas Plunk | Physical Therapy Assistant | 127 Medical Park Ln, Huntsville, TX 77340-4972 | 2013-08-07 |
| 1104061522 | Dustin Ken Bessire | Physical Therapist | 127 Medical Park Ln, Huntsville, TX 77340-4972 | 2008-12-15 |
| 1659547107 | Physical Therapy Associates | Specialist | 127 Medical Park Ln, Huntsville, TX 77340-4972 | 2008-05-05 |
| 1962557074 | Dallas Williams | Physical Therapist | 127 Medical Park Ln, Huntsville, TX 77340-4972 | 2007-01-25 |
| 1497763676 | Laura B. Garland | Physical Therapist | 127 Medical Park Ln, Huntsville, TX 77340-4972 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023619871 | Rhonda Reynolds | Pharmacist | 141 I45 S, Huntsville, TX 77340 | 2020-11-06 |
| 1902407794 | Tristan Elliston | Pharmacist | 145 Interstate 45 S, Huntsville, TX 77340 | 2020-11-06 |
| 1396362331 | Elizabeth Alexander | Registered Nurse | 1451 River Oaks Dr., Huntsville, TX 77340 | 2020-06-25 |
| 1598399107 | Haley Lord | Specialist/Technologist | 1804 Bobby K Marks Dr, Huntsville, TX 77340 | 2020-02-24 |
| 1568022077 | Jessica Olsen Jordan | Registered Nurse | 1905 University Ave, Huntsville, TX 77340 | 2019-06-17 |
| 1861962136 | Samantha Joleen Bioseh | Nurse Practitioner | 179 I-45, Suite 300, Huntsville, TX 77340 | 2018-11-29 |
| 1528573987 | Alan Wu | Dentist | 245 Interstate 45 S Ste D, Huntsville, TX 77340 | 2017-12-07 |
| 1285146282 | Brandi Elizabeth Bonin | Dietitian, Registered | 1217 Avenue M Ste 113, Huntsville, TX 77340 | 2017-10-30 |
| 1558889030 | Mext, LLC | Audiologist-Hearing Aid Fitter | 179 Ih 45 S Ste 400, Huntsville, TX 77340 | 2017-09-05 |
| 1720518111 | H-e-b, Lp | Clinical Medical Laboratory | 1702 11th St, Huntsville, TX 77340 | 2017-06-18 |
| Find all providers in zip 77340 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407417702 | Sasha J White | Specialist | 410 Governors Dr. Sw, Huntsville, AL 35801 | 2019-06-26 |
| 1235679135 | Fox Medical | Specialist | 540 I-45 South, Suite B, Huntsville, TX 77340 | 2017-02-27 |
| 1295146850 | Monica Anderson | Specialist | 417 Jordan Ln Nw, Huntsville, AL 35805-2623 | 2014-05-15 |
| 1184974800 | Jitesh K Kar | Specialist | 2006 Franklin St Se Ste 202a, Huntsville, AL 35801-4537 | 2012-09-11 |
| 1215213269 | David Clarke | Specialist | 6275 University Dr Nw Ste 37-395, Huntsville, AL 35806-1776 | 2011-10-21 |
| 1396904298 | Mark Thomas Matzek | Specialist | Therapy Services 1963 South Memorial Parkway, Suite 12, Huntsville, AL 35801-5035 | 2008-06-05 |
| 1740484856 | Purva Charudatta Varadkar | Specialist | 7047 Old Madison Pike Nw Ste 310, Huntsville, AL 35806-2188 | 2007-06-13 |
| 1942419643 | Cheryl C Bazzle | Specialist | 333 Whitesport Dr., Suite 103, Huntsville, AL 35801 | 2007-05-21 |
| 1245457613 | Leslie Ronald Taylor | Specialist | 8911 Seaton Dr Se, Huntsville, AL 35802-3646 | 2007-04-19 |
| 1902020142 | Anthony R. Alexander | Specialist | 220 Rhett Ave Sw, Suite C, Huntsville, AL 35801-4552 | 2007-04-12 |
| Find all providers in HUNTSVILLE | ||||
| City | HUNTSVILLE |
| Zip Code | 77340 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.