=====================================================
General NPI Number Information
=====================================================
NPI Number | 1093228108
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | POST-ACUTE PHYSICIANS OF IOWA, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/10/2017
-----------------------------------------------------
Last Update Date | 04/13/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1111 6TH AVE
-----------------------------------------------------
City | DES MOINES
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 50314-2613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-749-7428
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1776 WOODSTEAD CT STE 208
-----------------------------------------------------
City | THE WOODLANDS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77380-1480
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 877-749-7428
-----------------------------------------------------
Fax | 512-628-3314
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | JOSE L VARGAS
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 877-749-7428
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | MD42072
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------