Provider Demographics
NPI:1275752974
Name:TEXAS HAND REHABILITATION
Entity Type:Organization
Organization Name:TEXAS HAND REHABILITATION
Other - Org Name:TEXAS HAND REHABILITATION AND OCCUPATIONAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:AL
Authorized Official - Middle Name:
Authorized Official - Last Name:EFTEKHARI
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:972-613-3440
Mailing Address - Street 1:PO BOX 550372
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75355-0372
Mailing Address - Country:US
Mailing Address - Phone:972-613-3440
Mailing Address - Fax:972-613-3630
Practice Address - Street 1:2540 N GALLOWAY AVE
Practice Address - Street 2:SUITE 301-A
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6306
Practice Address - Country:US
Practice Address - Phone:972-613-3440
Practice Address - Fax:972-613-3630
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX509410000225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00272WMedicare ID - Type UnspecifiedMEDICARE NUMBER