Provider Demographics
NPI:1609810308
Name:R2 PARTNERS, LP
Entity Type:Organization
Organization Name:R2 PARTNERS, LP
Other - Org Name:DIRECT REHABMED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:RITESH
Authorized Official - Middle Name:R
Authorized Official - Last Name:PRASAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-593-9999
Mailing Address - Street 1:P.O. BOX 132929
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75713-2929
Mailing Address - Country:US
Mailing Address - Phone:903-593-9999
Mailing Address - Fax:903-526-4239
Practice Address - Street 1:3110 PARK CENTER DR.
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-9215
Practice Address - Country:US
Practice Address - Phone:903-593-9999
Practice Address - Fax:903-526-4239
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2012-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 225100000X
TX6215111N00000X
TXK1283208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXOOW166Medicare PIN