Provider Demographics
NPI:1548338528
Name:CABA THERAPY SERVICES
Entity type:Organization
Organization Name:CABA THERAPY SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERIC
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:CARR
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:281-424-7557
Mailing Address - Street 1:PO BOX 7287
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77522-7205
Mailing Address - Country:US
Mailing Address - Phone:281-424-7557
Mailing Address - Fax:281-424-7567
Practice Address - Street 1:3818 DECKER DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-1662
Practice Address - Country:US
Practice Address - Phone:281-424-7557
Practice Address - Fax:281-424-7567
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-30
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX652560000225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX103947901OtherUS DEPT OF LABOR
TX6362783OtherCIGNA
TX7615482OtherAETNA
TX103947900OtherUS DEPT OF LABOR
TX686248OtherUNITED HEALTHCAREACN
TX0003KXOtherBLUE CROSS BLUE SHIELD
TX686248OtherUNITED HEALTHCAREACN