Healthcare Provider Details

I. General information

NPI: 1811207848
Provider Name (Legal Business Name): NATIONAL NURSING AND REHAB SA PEDIATRICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/08/2010
Last Update Date: 03/27/2025
Certification Date: 03/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 NE LOOP 410 STE 690
SAN ANTONIO TX
78216-5831
US

IV. Provider business mailing address

45 NE LOOP 410 STE 690
SAN ANTONIO TX
78216-5831
US

V. Phone/Fax

Practice location:
  • Phone: 210-822-0475
  • Fax: 210-822-0485
Mailing address:
  • Phone: 210-822-0475
  • Fax: 210-822-0485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number014065
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number014065
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number014065
License Number StateTX
# 6
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number014065
License Number StateTX

VIII. Authorized Official

Name: MR. MARC J PICTROWSKI
Title or Position: REGIONAL DIRECTOR OF TEXAS OPS
Credential: PT
Phone: 210-822-0475