Provider Demographics
NPI:1740572148
Name:INFINITY REHAB SERVICES, LLC
Entity Type:Organization
Organization Name:INFINITY REHAB SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAULA
Authorized Official - Middle Name:DEGLEY
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:956-361-2300
Mailing Address - Street 1:2224 S 77 SUNSHINE STP
Mailing Address - Street 2:STE 96 PMB#111
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550
Mailing Address - Country:US
Mailing Address - Phone:956-361-2300
Mailing Address - Fax:956-361-2391
Practice Address - Street 1:115 N WILLIAMS ROAD
Practice Address - Street 2:STE. A
Practice Address - City:SAN BENITO
Practice Address - State:TX
Practice Address - Zip Code:78586
Practice Address - Country:US
Practice Address - Phone:956-361-2300
Practice Address - Fax:956-361-2391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-04
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111706225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty