Healthcare Provider Details

I. General information

NPI: 1730234840
Provider Name (Legal Business Name): EL PASO REHABILITATION CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E SCHUSTER AVE
EL PASO TX
79902-4659
US

IV. Provider business mailing address

1101 E SCHUSTER AVE
EL PASO TX
79902-4659
US

V. Phone/Fax

Practice location:
  • Phone: 915-544-8484
  • Fax: 915-496-0751
Mailing address:
  • Phone: 915-544-8484
  • Fax: 915-496-0751

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1145027
License Number StateTX

VIII. Authorized Official

Name: MR. JAIME BARCELEAU
Title or Position: EXECUTIVE DIRECTOR
Credential: LMSW
Phone: 915-544-8484