1225569239 NPI number — THE REHAB FIRM, INC.

Table of content: (NPI 1225569239)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225569239 NPI number — THE REHAB FIRM, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE REHAB FIRM, 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:
STACI LYNN TIBBS & ASSOCIATES, INC.
Provider Other Organization Name Type Code:
4
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:
1225569239
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11601 SHADOW CREEK PKWY STE 111-216
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEARLAND
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77584-7283
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-280-3663
Provider Business Mailing Address Fax Number:
855-710-7269

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13212 LONE CREEK LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARLAND
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77584-3476
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-280-3663
Provider Business Practice Location Address Fax Number:
855-710-7269
Provider Enumeration Date:
03/22/2017

Additional Information

Authorized Official

Authorized Official Last Name:
WILSON
Authorized Official First Name:
STACI
Authorized Official Middle Name:
TIBBS
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
713-280-3663

Provider Taxonomy Codes

  • Taxonomy code: 225X00000X , with the licence number:  112297 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XG0600X , with the licence number: 112297 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225XL0004X , with the licence number: 112297 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225XN1300X , with the licence number: 112297 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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