Provider Demographics
NPI:1730674920
Name:DRMC REHAB PLLC
Entity type:Organization
Organization Name:DRMC REHAB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:COUGHLAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-724-5755
Mailing Address - Street 1:11000 BRUNEAU TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5705
Mailing Address - Country:US
Mailing Address - Phone:314-724-5755
Mailing Address - Fax:570-366-5032
Practice Address - Street 1:1400 HESTERS CROSSING RD
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-8025
Practice Address - Country:US
Practice Address - Phone:314-724-5755
Practice Address - Fax:570-366-5032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-29
Last Update Date:2018-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty