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General NPI Number Information
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NPI Number | 1669457842
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Entity Type | Organization
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Legal Business Name | OPTIMUM REHABILITATION LTD
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Dates
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Enumeration Date | 12/12/2005
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Last Update Date | 06/06/2008
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Provider Practice Location Address
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Address Line | 3120 HWY 36 S
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City | BRENHAM
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State | TX
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Zip | 77833
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Country | US
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Telephone | 979-277-9186
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Fax | 979-277-9924
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Provider Business Mailing Address
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Address Line | 3120 HWY 36 S
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City | BRENHAM
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State | TX
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Zip | 77833
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Country | US
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Telephone | 979-277-9186
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Fax | 979-277-9924
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Authorized Official
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Title or Position | INSURANCE BILLING SPECIALIST
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Name | MS. VIRGINIA YOLANDA DABERA
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Credential |
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Telephone | 979-277-9186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 100446
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1026052
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License Number State | TX
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