Provider Demographics
NPI:1134309768
Name:REHAB TEX PHYSICAL THERAPY INC.
Entity Type:Organization
Organization Name:REHAB TEX PHYSICAL THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:PINEDA-FALDAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:951-310-1130
Mailing Address - Street 1:647 SHENANDOAH RD
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92879-8509
Mailing Address - Country:US
Mailing Address - Phone:951-310-1130
Mailing Address - Fax:877-563-5027
Practice Address - Street 1:647 SHENANDOAH RD
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-8509
Practice Address - Country:US
Practice Address - Phone:951-310-1130
Practice Address - Fax:877-563-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-12
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT25778251E00000X, 261QP2000X, 261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)