Provider Demographics
NPI:1861730293
Name:REHAB NETWORK, INC
Entity type:Organization
Organization Name:REHAB NETWORK, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:210-615-0400
Mailing Address - Street 1:4801 FREDERICKSBURG RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3693
Mailing Address - Country:US
Mailing Address - Phone:210-615-0400
Mailing Address - Fax:210-615-0040
Practice Address - Street 1:4801 FREDERICKSBURG RD
Practice Address - Street 2:SUITE A
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3693
Practice Address - Country:US
Practice Address - Phone:210-615-0400
Practice Address - Fax:210-615-0040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX11370398OtherCAQH