Provider Demographics
NPI:1033416458
Name:ADVANCED REHABILITATION CLINICS OF TEXAS L.L.P.
Entity Type:Organization
Organization Name:ADVANCED REHABILITATION CLINICS OF TEXAS L.L.P.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:MIGUEL
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARVAJAL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-779-6040
Mailing Address - Street 1:2650 FOUNTAIN VIEW DR STE 424
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-7620
Mailing Address - Country:US
Mailing Address - Phone:713-779-6040
Mailing Address - Fax:713-779-6540
Practice Address - Street 1:2650 FOUNTAIN VIEW DR STE 424
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-7620
Practice Address - Country:US
Practice Address - Phone:713-779-6040
Practice Address - Fax:713-779-6540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-21
Last Update Date:2011-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8339261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center