MEDICARE: PHYSICIANS REHAB ASSOCIATES P. A.

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
1	111N00000X	Chiropractor	6852	TX

General Provider Information

NPI Number	:	1366630980
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICIANS REHAB ASSOCIATES P. A.

Provider Business Mailing Address
First Line	:	3708 N NAVARRO ST
Second Line	:	SUITE C
City	:	VICTORIA
State	:	TX
Zip	:	77901-2619
Country	:	US
Telephone Number	:	361-570-7354
Fax Number	:	361-570-7356

Provider Business Practice Location Address
First Line	:	3708 N NAVARRO ST
Second Line	:	SUITE C
City	:	VICTORIA
State	:	TX
Zip	:	77901-2619
Country	:	US
Telephone Number	:	361-570-7354
Fax Number	:	361-570-7356

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LARRY DOWLING DEES
Credential	:	D.C.
Telephone Number	:	361-570-7354

Provider Enumeration Date	:	10/09/2007
Last Update Date	:	10/09/2007

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