=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245651355
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | REHABSCOPE CONSULTANTS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/17/2013
-----------------------------------------------------
Last Update Date | 12/17/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9801 STONELAKE BLVD #1333
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78759-5940
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-321-7420
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4308 BELLVUE AVE
-----------------------------------------------------
City | AUSTIN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78756-3417
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 586-321-7420
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MEMBER
-----------------------------------------------------
Name | DR. ANUREET KAUR BRAR
-----------------------------------------------------
Credential | D.O.
-----------------------------------------------------
Telephone | 586-321-7420
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208100000X
-----------------------------------------------------
Taxonomy Name | Physical Medicine & Rehabilitation Physician
-----------------------------------------------------
License Number | P7077
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------