1326226937 NPI number — INTEGRITY REHAB INC

Table of content: (NPI 1326226937)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326226937 NPI number — INTEGRITY REHAB INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INTEGRITY REHAB INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326226937
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7330 SAN PEDRO AVE
Provider Second Line Business Mailing Address:
SUITE 410
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78216-6235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-979-3800
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1222 N MAIN AVE
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78212-5712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-226-2101
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/06/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CASEY
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
JOSEPH
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
210-979-3800

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1059087 . This is a "LICENSE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".