Healthcare Provider Details

I. General information

NPI: 1235674615
Provider Name (Legal Business Name): ZOOM REHABILITATION,INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 06/02/2022
Certification Date: 11/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1108 N ESPLANADE ST
CUERO TX
77954-3434
US

IV. Provider business mailing address

9606 NE ZAC LENTZ PKWY
VICTORIA TX
77904-3115
US

V. Phone/Fax

Practice location:
  • Phone: 361-541-5915
  • Fax: 361-541-4412
Mailing address:
  • Phone: 361-237-1670
  • Fax: 361-237-1703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRIS STEFKA
Title or Position: ADMINISTRATOR
Credential:
Phone: 361-237-1670