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General NPI Number Information
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NPI Number | 1770004483
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Entity Type | Organization
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Legal Business Name | RGV PHYSICAL THERAPY & AQUATIC REHAB, LLC
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Dates
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Enumeration Date | 07/03/2017
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Last Update Date | 07/03/2017
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Provider Practice Location Address
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Address Line | 515 E BUSINESS HWY 83 STE B
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City | ALAMO
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State | TX
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Zip | 78516-2526
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Country | US
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Telephone | 956-460-7840
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Fax | 956-720-4222
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Provider Business Mailing Address
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Address Line | 1132 S 7TH ST
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City | ALAMO
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State | TX
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Zip | 78516-6993
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Country | US
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Telephone | 956-460-7840
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JORGE ESCOBEDO
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Credential | PT
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Telephone | 956-460-7840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1112498
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License Number State | TX
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