Provider Demographics
NPI:1073737805
Name:SOUTH TEXAS REHABILITATION & HAND THERAPY LLP
Entity Type:Organization
Organization Name:SOUTH TEXAS REHABILITATION & HAND THERAPY LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-787-0962
Mailing Address - Street 1:1104B W SAM HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-5104
Mailing Address - Country:US
Mailing Address - Phone:956-787-0962
Mailing Address - Fax:956-787-1564
Practice Address - Street 1:1104B W SAM HOUSTON ST
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-5104
Practice Address - Country:US
Practice Address - Phone:956-787-0962
Practice Address - Fax:956-787-1564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10267712251X0800X
TX107359225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175010101Medicaid
TX175010101Medicaid