Provider Demographics
NPI:1386689669
Name:REHABILITATION MEDICINE SPECIALISTS
Entity Type:Organization
Organization Name:REHABILITATION MEDICINE SPECIALISTS
Other - Org Name:SPINEABILENE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FACILITY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:A
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-795-1888
Mailing Address - Street 1:1888 ANTILLEY RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5205
Mailing Address - Country:US
Mailing Address - Phone:325-795-1888
Mailing Address - Fax:325-795-9537
Practice Address - Street 1:1888 ANTILLEY RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5205
Practice Address - Country:US
Practice Address - Phone:325-795-1888
Practice Address - Fax:325-795-9537
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-19
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2508174400000X
TXJ2625174400000X
TXM3408174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5779430OtherAETNA
TX00J94HOtherBCBS
TXCS3605OtherMEDICARE RR
TX00J94HOtherBCBS