Healthcare Provider Details

I. General information

NPI: 1851057442
Provider Name (Legal Business Name): RGV REHAB THERAPY SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2021
Last Update Date: 11/09/2021
Certification Date: 11/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 N JACKSON RD STE B
MCALLEN TX
78504-6100
US

IV. Provider business mailing address

1900 S JACKSON RD STE 3
MCALLEN TX
78503-1589
US

V. Phone/Fax

Practice location:
  • Phone: 956-630-4400
  • Fax: 956-630-4447
Mailing address:
  • Phone: 956-630-4400
  • Fax: 956-630-4447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: JORGE A GONZALEZ
Title or Position: ADMINISTRATOR/OWNER/CFO
Credential:
Phone: 956-630-4400