MEDICARE: CENTER POINTE HEALTH REHAB 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
1	261QR0400X	Rehabilitation Clinic/Center	J6969	TX

General Provider Information

NPI Number	:	1538394812
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTER POINTE HEALTH REHAB LLC

Provider Business Mailing Address
First Line	:	2000 S MCCOLL RD
Second Line	:	STE B PMB 226
City	:	MCALLEN
State	:	TX
Zip	:	78503-1501
Country	:	US
Telephone Number	:	956-668-7900
Fax Number	:	956-668-7904

Provider Business Practice Location Address
First Line	:	3218 W ALBERTA RD
Second Line	:
City	:	EDINBURG
State	:	TX
Zip	:	78539-9635
Country	:	US
Telephone Number	:	956-668-7900
Fax Number	:	956-668-7904

Authorized Official
Title or Position	:	DR / OWNER
Name	:	LUIS M GONZALEZ
Credential	:	M.D.
Telephone Number	:	956-668-7900

Provider Enumeration Date	:	05/15/2009
Last Update Date	:	06/11/2009

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