Provider Demographics
NPI:1922293596
Name:HIGH PLAINS REHABILITATION ASSO.
Entity Type:Organization
Organization Name:HIGH PLAINS REHABILITATION ASSO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:R
Authorized Official - Last Name:VEGGEBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-353-7018
Mailing Address - Street 1:PO BOX 8876
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79114-8876
Mailing Address - Country:US
Mailing Address - Phone:806-353-7018
Mailing Address - Fax:806-353-7044
Practice Address - Street 1:5111 CANYON DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79110-3037
Practice Address - Country:US
Practice Address - Phone:806-353-7018
Practice Address - Fax:806-353-7044
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-07
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8478174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081770201Medicaid
TX081770201Medicaid