Healthcare Provider Details

I. General information

NPI: 1861805764
Provider Name (Legal Business Name): ZOOM REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2014
Last Update Date: 04/02/2024
Certification Date: 04/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E AIRLINE RD
VICTORIA TX
77901-4000
US

IV. Provider business mailing address

1101 E AIRLINE RD
VICTORIA TX
77901-4000
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRIS STEFKA
Title or Position: ADMINISTRATOR
Credential:
Phone: 361-541-5571