MEDICARE: MCCOMBS REHABILITATION CENTER

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	261Q00000X	Clinic/Center	DC2198	TX

General Provider Information

NPI Number	:	1578720744
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCCOMBS REHABILITATION CENTER

Provider Business Mailing Address
First Line	:	PO BOX 24331
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79914-5331
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4717 HONDO PASS DR STE B
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79904-1474
Country	:	US
Telephone Number	:	915-755-4636
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DOLORES WEBB
Credential	:	DC
Telephone Number	:	915-755-4636

Provider Enumeration Date	:	05/16/2008
Last Update Date	:	05/16/2008

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