1538394812 NPI number — CENTER POINTE HEALTH REHAB LLC

Table of content: (NPI 1538394812)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538394812 NPI number — CENTER POINTE HEALTH REHAB LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER POINTE HEALTH REHAB LLC
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:
1538394812
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2000 S MCCOLL RD
Provider Second Line Business Mailing Address:
STE B PMB 226
Provider Business Mailing Address City Name:
MCALLEN
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78503-1501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
956-668-7900
Provider Business Mailing Address Fax Number:
956-668-7904

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3218 W ALBERTA RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDINBURG
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78539-9635
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-668-7900
Provider Business Practice Location Address Fax Number:
956-668-7904
Provider Enumeration Date:
05/15/2009

Additional Information

Authorized Official

Authorized Official Last Name:
GONZALEZ
Authorized Official First Name:
LUIS
Authorized Official Middle Name:
M
Authorized Official Title or Position:
DR / OWNER
Authorized Official Telephone Number:
956-668-7900

Provider Taxonomy Codes

  • Taxonomy code: 261QR0400X , with the licence number:  J6969 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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