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General NPI Number Information
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NPI Number | 1689956732
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Entity Type | Organization
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Legal Business Name | EDINBURG PROFESSIONAL REHABILITATION CENTER, LLC
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 09/14/2011
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Provider Practice Location Address
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Address Line | 5113 S JACKSON RD
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City | EDINBURG
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State | TX
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Zip | 78539-3184
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Country | US
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Telephone | 956-683-8000
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Fax | 956-683-8673
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Provider Business Mailing Address
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Address Line | 5113 S JACKSON RD
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City | EDINBURG
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State | TX
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Zip | 78539-3184
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Country | US
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Telephone | 956-683-8000
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Fax | 956-683-8673
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MR. MARCOS MORAN
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Credential |
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Telephone | 956-784-9874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 224Z00000X
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Taxonomy Name | Occupational Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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