Provider Demographics
NPI:1033483110
Name:TEXAS MEDICAL REHAB, P. A.
Entity Type:Organization
Organization Name:TEXAS MEDICAL REHAB, P. A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PREISIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:LEONARD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-687-8488
Mailing Address - Street 1:404 LINDBERG AVE
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2922
Mailing Address - Country:US
Mailing Address - Phone:956-687-8488
Mailing Address - Fax:956-687-2540
Practice Address - Street 1:404 LINDBERG AVE
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2922
Practice Address - Country:US
Practice Address - Phone:956-687-8488
Practice Address - Fax:956-687-2540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-07
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF97282081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C18329Medicare UPIN