Provider Demographics
NPI:1891915369
Name:PROGRESSIVE REHABILITATION, INC.
Entity Type:Organization
Organization Name:PROGRESSIVE REHABILITATION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-250-9140
Mailing Address - Street 1:13729 RESEARCH BLVD
Mailing Address - Street 2:STE 610-115
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-1883
Mailing Address - Country:US
Mailing Address - Phone:512-250-9140
Mailing Address - Fax:512-250-2207
Practice Address - Street 1:5004 LAKEVIEW DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1719
Practice Address - Country:US
Practice Address - Phone:512-250-9140
Practice Address - Fax:512-250-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-26
Last Update Date:2010-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy AssistantGroup - Multi-Specialty
No225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00756EOtherBLUE CROSS
TXDD6871OtherRAILROAD MEDICARE
TX00755EOtherBLUE CROSS
TX081104401Medicaid
TX081106901Medicaid
TX00756EMedicare ID - Type Unspecified
TXDD6871OtherRAILROAD MEDICARE