Provider Demographics
NPI:1508585225
Name:REHABILITATION PHYSICIAN SERVICES, PLLC
Entity Type:Organization
Organization Name:REHABILITATION PHYSICIAN SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEKSANDER
Authorized Official - Middle Name:S
Authorized Official - Last Name:BORRESEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:832-423-0885
Mailing Address - Street 1:PO BOX 181276
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78480-1276
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:361-371-4506
Practice Address - Street 1:5726 ESPLANADE DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4165
Practice Address - Country:US
Practice Address - Phone:361-906-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1609373018Medicaid
AL1609373018Medicaid