MEDICARE: REHABILITATION 469, PLLC

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	207L00000X	Anesthesiology Physician

General Provider Information

NPI Number	:	1649787680
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REHABILITATION 469, PLLC

Provider Business Mailing Address
First Line	:	1141 N LOOP 1604 E # 105-612
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-1339
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5956 SHERRY LANE, 20TH FLOOR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75225
Country	:	US
Telephone Number	:	210-598-4277
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JARROD ROGERS
Credential	:
Telephone Number	:	214-577-9191

Provider Enumeration Date	:	12/29/2017
Last Update Date	:	02/06/2026

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