BACKTOGOLF PERFORMANCE CENTER, LLC (NPI# 1922202126) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922202126 |
| Entity Type | Organization |
| Organization Name | BACKTOGOLF PERFORMANCE CENTER, LLC |
| Practice Address |
7401 State Highway 45 Austin TX 78739-1901 |
| Mailing Address |
11318 Aden Ct Austin TX 78739-1589 |
| Practice Telephone | 5123717687 |
| Practice Fax Number | 5123717601 |
| Mailing Telephone | 5123717687 |
| Mailing Fax Number | 5123717601 |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | M. JAY PLATT (PRESIDENT) |
| Authorized Official Telephone | 5123717687 |
| Authorized Official Credential | P.T. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251S0007X |
Physical Therapist Specialization: Sports |
1029148 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | BCBS GROUP NUMBER | 0089GJ | 01 |
| Street Address |
7401 STATE HIGHWAY 45 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78739-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871002188 | Cole Stutz | Physical Therapist | 5401 La Crosse Ave., Building C, Suite 101, Austin, TN 78739 | 2017-09-29 |
| 1346796992 | Amanda Sylvie | Dietitian, Registered | 6604 Nusser Ln, Austin, TX 78739 | 2016-09-01 |
| 1609259431 | Marjan Aryannejad | Pharmacist | 10805 Tollesboro Cove, Austin, TX 78739 | 2015-06-29 |
| 1780071563 | Lauren Vaughn | Counselor | 11228 South Bay Lane, Austin, TX 78739 | 2015-04-20 |
| 1649552860 | Purvi Patel | Pharmacist | 12212 Tuberose Ter, Austin, TX 78739 | 2011-09-14 |
| 1780915124 | Stephanie Ann Etie | Behavioral Analyst | 5924 Rickerhill Ln, Austin, TX 78739 | 2010-01-25 |
| 1972724730 | Qiao Xu | Acupuncturist | 11236 South Bay Lane, Austin, TX 78739 | 2007-05-01 |
| 1740382084 | Ferril Chris Smith | Internal Medicine | 4104 Reynosa Dr, Austin, TX 78739 | 2006-09-05 |
| 1295235992 | Sally Elizabeth Stroud | Registered Nurse | 6405 Back Bay Ln, Austin, TX 78739-1402 | 2018-02-19 |
| 1982262317 | Adrienne Lee Wiggins | Registered Nurse | 6407 Old Harbor Ln, Austin, TX 78739-1405 | 2019-05-31 |
| Find all providers in zip 78739 | ||||
| Taxonomy Code | 2251S0007X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Sports |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053524181 | James Allen Hardin | Physical Therapist | 5806 Buckpasser Cv, Austin, TX 78746-1450 | 2007-05-07 |
| 1699876250 | Jacon C Chun | Physical Therapist | 11150 Research Blvd Ste 212, Austin, TX 78759-5243 | 2006-09-26 |
| 1902163843 | Ascent Physical Therapy, PC | Physical Therapist | 2712 Bee Cave Rd, #110, Austin, TX 78746-5676 | 2012-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811506157 | Emma Julia Regenbaum | Physical Therapist | 19200 Preston Rd # 120, Dallas, TX 75252-2450 | 2020-07-22 |
| 1629603592 | Dorcas Copa | Physical Therapist | 1612 Stuart St, Houston, TX 77004-2945 | 2020-03-11 |
| 1669007761 | Kyle Barnett | Physical Therapist | 14216 Vernon Ave, Lubbock, TX 79423-7715 | 2020-03-09 |
| 1023643517 | Kevin Maloney | Physical Therapist | 2206 Stuart St, Houston, TX 77004-3151 | 2020-03-05 |
| 1427682673 | Thomas Latimore | Physical Therapist | 9305 Pinecroft Dr Ste 450, The Woodlands, TX 77380-3483 | 2020-02-26 |
| 1871127001 | Steven Higbie | Physical Therapist | 17520 W Grand Pkwy S Ste 100, Sugar Land, TX 77479-4759 | 2020-02-26 |
| 1841830122 | Justin C Tallard | Physical Therapist | 4885 Alpha Rd Ste 135, Dallas, TX 75244-4637 | 2020-01-14 |
| 1881234474 | Brian Nguyen | Physical Therapist | 16636 House Hahl Rd, Cypress, TX 77433-5357 | 2020-01-10 |
| 1992355622 | Steven Islas | Physical Therapist | 2700 W Sam Houston Pkwy N, Houston, TX 77043-1608 | 2019-09-15 |
| 1316591886 | John Walter Warner Jr. | Physical Therapist | 18200 Katy Fwy. Wa.0540.01, Houston, TX 77094 | 2019-08-01 |
| Find all providers with the same taxonomy | ||||
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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.