Provider Demographics
NPI:1467404129
Name:ROUND ROCK WOUND & REHAB CENTER, LP
Entity Type:Organization
Organization Name:ROUND ROCK WOUND & REHAB CENTER, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-440-1441
Mailing Address - Street 1:1701 W BEN WHITE BLVD
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7667
Mailing Address - Country:US
Mailing Address - Phone:512-440-1441
Mailing Address - Fax:512-440-1448
Practice Address - Street 1:310 W MAIN AVE
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-5830
Practice Address - Country:US
Practice Address - Phone:512-246-2262
Practice Address - Fax:512-246-2261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0095JZOtherBC/BS OF TX
TX00618XOtherMEDICARE B
TX0095JZOtherBC/BS OF TX