1154413359 NPI number — TOTAL REHABILITATION OF HARLINGEN LTD

Table of content: (NPI 1154413359)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154413359 NPI number — TOTAL REHABILITATION OF HARLINGEN LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL REHABILITATION OF HARLINGEN LTD
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:
1154413359
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/14/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
595 W SESAME DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARLINGEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78550-7962
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-428-5440
Provider Business Mailing Address Fax Number:
956-428-3375

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
595 W SESAME DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-7962
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-428-5440
Provider Business Practice Location Address Fax Number:
956-428-3375
Provider Enumeration Date:
09/28/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SALDANA
Authorized Official First Name:
MARC
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
956-428-5440

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  653000000 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 204544800 . This is a "ACS DEPT OF LABOR" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 166500201 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: A001 . This is a "TRICARE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 0078KX . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 134682101 . This is a "VALLEY HEALTH PLANS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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