Provider Demographics
NPI:1871034751
Name:PIEDRAS REHABILITATION CLINIC LLC
Entity Type:Organization
Organization Name:PIEDRAS REHABILITATION CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LYNNETTE
Authorized Official - Middle Name:S
Authorized Official - Last Name:LOMARQUEZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:915-474-0390
Mailing Address - Street 1:1351 N ZARAGOZA
Mailing Address - Street 2:BLDG Q
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936
Mailing Address - Country:US
Mailing Address - Phone:915-704-4065
Mailing Address - Fax:915-704-4067
Practice Address - Street 1:1351 N ZARAGOZA
Practice Address - Street 2:BLDG Q
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936
Practice Address - Country:US
Practice Address - Phone:915-704-4065
Practice Address - Fax:915-704-4067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-13
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation