Provider Demographics
NPI:1912398074
Name:ABP REHAB SERVICES PC
Entity Type:Organization
Organization Name:ABP REHAB SERVICES PC
Other - Org Name:AUTISM & BEHAVIORAL PEDIATRIC REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HECTOR
Authorized Official - Middle Name:MANUEL
Authorized Official - Last Name:ADAME
Authorized Official - Suffix:
Authorized Official - Credentials:CCC-SLP, BCBA
Authorized Official - Phone:915-704-1094
Mailing Address - Street 1:4700 N MESA ST STE F4
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-6187
Mailing Address - Country:US
Mailing Address - Phone:915-704-1094
Mailing Address - Fax:915-533-3803
Practice Address - Street 1:4700 N MESA ST STE F4
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-6187
Practice Address - Country:US
Practice Address - Phone:915-704-1094
Practice Address - Fax:915-533-3803
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-11
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106366235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty