Provider Demographics
NPI:1568568590
Name:DEL RIO PHYSICAL THERAPY AND REHABILITATION CENTER INC
Entity Type:Organization
Organization Name:DEL RIO PHYSICAL THERAPY AND REHABILITATION CENTER INC
Other - Org Name:DEL RIO PHYSICAL THERAPY AND REHABILITATION CENTER INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR/CO OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:SHAWN
Authorized Official - Last Name:GARMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-775-9118
Mailing Address - Street 1:710 N BEDELL AVE
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-4111
Mailing Address - Country:US
Mailing Address - Phone:830-775-9118
Mailing Address - Fax:830-775-9229
Practice Address - Street 1:710 N BEDELL AVE
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-4111
Practice Address - Country:US
Practice Address - Phone:830-775-9118
Practice Address - Fax:830-775-9229
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX235Z00000X, 261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Not Answered261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX676529Medicare ID - Type UnspecifiedPATIENT REHAB FACILITY