MEDICARE: ABP REHAB SERVICES PC

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	235Z00000X	Speech-Language Pathologist	106366	TX

General Provider Information

NPI Number	:	1912398074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ABP REHAB SERVICES PC

Provider Business Mailing Address
First Line	:	4700 N MESA ST STE F4
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-6187
Country	:	US
Telephone Number	:	915-704-1094
Fax Number	:	915-533-3803

Provider Business Practice Location Address
First Line	:	4700 N MESA ST STE F4
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-6187
Country	:	US
Telephone Number	:	915-704-1094
Fax Number	:	915-533-3803

Authorized Official
Title or Position	:	PRESIDENT
Name	:	HECTOR MANUEL ADAME
Credential	:	CCC-SLP, BCBA
Telephone Number	:	915-704-1094

Provider Enumeration Date	:	02/11/2015
Last Update Date	:	03/30/2016

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Directions to “ABP REHAB SERVICES PC ” Practice Location

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