Provider Demographics
NPI:1790969020
Name:SCHREIBER UPPER EXTREMITY REHAB, P.C.
Entity Type:Organization
Organization Name:SCHREIBER UPPER EXTREMITY REHAB, P.C.
Other - Org Name:TERESA SCHREIBER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHREIBER
Authorized Official - Suffix:
Authorized Official - Credentials:MA, OTR,CHT
Authorized Official - Phone:940-766-1515
Mailing Address - Street 1:PO BOX 8186
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76307-8186
Mailing Address - Country:US
Mailing Address - Phone:940-766-1515
Mailing Address - Fax:940-766-1539
Practice Address - Street 1:1500 BROOK AVE
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-5604
Practice Address - Country:US
Practice Address - Phone:940-766-1515
Practice Address - Fax:940-766-1539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-21
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103539174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6102560001Medicare NSC