Provider Demographics
NPI:1609126499
Name:PNI REHAB CENTERS, LLC
Entity Type:Organization
Organization Name:PNI REHAB CENTERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:DASILVA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-436-4434
Mailing Address - Street 1:363 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-3867
Mailing Address - Country:US
Mailing Address - Phone:972-436-4434
Mailing Address - Fax:
Practice Address - Street 1:363 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-3867
Practice Address - Country:US
Practice Address - Phone:972-436-4434
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7121111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX605665Medicaid
TXU65752Medicare UPIN