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NPI Code Detail

MEDICARE: VIBRA HOSPITAL OF LAKE TRAVIS LLC

MEDICARE: VIBRA HOSPITAL OF LAKE TRAVIS LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1283X00000XRehabilitation Hospital

General Provider Information

NPI Number : 1194137364
Entity Type Code : Organization
Provider Name (Legal Business Name) : VIBRA HOSPITAL OF LAKE TRAVIS LLC
Provider Business Mailing Address
First Line : 8081 ROYAL RIDGE PKWY
Second Line : SUITE 120
City : IRVING
State : TX
Zip : 75063-2818
Country : US
Telephone Number : 559-892-2450
Fax Number : 559-892-2442
Provider Business Practice Location Address
First Line : 2000 MEDICAL DRIVE
Second Line :
City : LAKEWAY
State : TX
Zip : 78734-4200
Country : US
Telephone Number : 512-263-4500
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. BRAD E HOLLINGER
Credential :
Telephone Number : 717-591-5700
Provider Enumeration Date : 05/22/2014
Last Update Date : 11/18/2015

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Directions to “VIBRA HOSPITAL OF LAKE TRAVIS LLC ” Practice Location

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