Provider Demographics
NPI:1396866158
Name:PREMIER HAND & UPPER EXTREMITY REHABILITATION, P.C.
Entity Type:Organization
Organization Name:PREMIER HAND & UPPER EXTREMITY REHABILITATION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBLES-MEADOWS
Authorized Official - Suffix:
Authorized Official - Credentials:OT, CHT, MBA
Authorized Official - Phone:210-694-5900
Mailing Address - Street 1:9150 HUEBNER RD
Mailing Address - Street 2:STE 170
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1558
Mailing Address - Country:US
Mailing Address - Phone:210-694-5900
Mailing Address - Fax:210-694-5910
Practice Address - Street 1:9150 HUEBNER RD
Practice Address - Street 2:STE 170
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-1558
Practice Address - Country:US
Practice Address - Phone:210-694-5900
Practice Address - Fax:210-694-5910
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5961620001Medicare NSC