MEDICARE: CENTRAL AUSTIN REHABILITATION, PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208100000X	Physical Medicine & Rehabilitation Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417926379
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTRAL AUSTIN REHABILITATION, PLLC

Provider Business Mailing Address
First Line	:	PO BOX 163895
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78716-3895
Country	:	US
Telephone Number	:	817-284-9850
Fax Number	:	817-284-9859

Provider Business Practice Location Address
First Line	:	3207 RANCH ROAD 620 S STE B
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78738-6872
Country	:	US
Telephone Number	:	817-284-9850
Fax Number	:	817-284-9859

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. LISA LEE
Credential	:
Telephone Number	:	817-284-9850

Provider Enumeration Date	:	03/14/2006
Last Update Date	:	06/02/2025

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