Provider Demographics
NPI:1427021245
Name:RGV REHAB CENTER, LLC
Entity Type:Organization
Organization Name:RGV REHAB CENTER, LLC
Other - Org Name:RGV REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:ESPARZA
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:956-630-4400
Mailing Address - Street 1:1900 S. JACKSON RD
Mailing Address - Street 2:SUITE 2-3
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1589
Mailing Address - Country:US
Mailing Address - Phone:956-630-4400
Mailing Address - Fax:956-630-4447
Practice Address - Street 1:4925 S JACKSON RD STE A
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-7207
Practice Address - Country:US
Practice Address - Phone:956-618-2588
Practice Address - Fax:956-630-4447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-10
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0400X
TX176731101261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX176731101Medicaid
TX176731101Medicaid