Provider Demographics
NPI:1710027719
Name:WORKERS COMPENSATION ASSISTANCE CLINIC
Entity Type:Organization
Organization Name:WORKERS COMPENSATION ASSISTANCE CLINIC
Other - Org Name:WORKERS COMP REHAB CLINIC INC.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENZUELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-521-1244
Mailing Address - Street 1:1231 AGNES
Mailing Address - Street 2:SUITE A9
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78403
Mailing Address - Country:US
Mailing Address - Phone:361-884-8770
Mailing Address - Fax:361-884-8710
Practice Address - Street 1:5732 WURZBACH RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1747
Practice Address - Country:US
Practice Address - Phone:210-521-1244
Practice Address - Fax:210-521-7324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF006281261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation