Provider Demographics
NPI:1225232150
Name:ZAPATA COUNTY MEDICAL GROUP REHAB SERVICES
Entity Type:Organization
Organization Name:ZAPATA COUNTY MEDICAL GROUP REHAB SERVICES
Other - Org Name:ZAPATA COUNTY MEDICAL GROUP REHAB SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MA. ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTOS
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:956-712-0770
Mailing Address - Street 1:2329 STOP23B # 83
Mailing Address - Street 2:
Mailing Address - City:ZAPATA
Mailing Address - State:TX
Mailing Address - Zip Code:78076-3001
Mailing Address - Country:US
Mailing Address - Phone:956-342-1209
Mailing Address - Fax:
Practice Address - Street 1:2329 STOP23B # 83
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-3001
Practice Address - Country:US
Practice Address - Phone:956-342-1209
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00882ZMedicare ID - Type UnspecifiedMEDICARE NUMBER