Provider Demographics
NPI:1942217377
Name:ATX REHAB PLLC
Entity Type:Organization
Organization Name:ATX REHAB PLLC
Other - Org Name:ADVANCED REHABILITATION PC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:J
Authorized Official - Last Name:ZELINSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:512-289-1424
Mailing Address - Street 1:10601 RANCH ROAD 2222
Mailing Address - Street 2:SUITE R52
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78730-1134
Mailing Address - Country:US
Mailing Address - Phone:512-289-1424
Mailing Address - Fax:512-467-1101
Practice Address - Street 1:6611 RIVER PLACE BLVD
Practice Address - Street 2:SUITE 302
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78730-1162
Practice Address - Country:US
Practice Address - Phone:512-467-1100
Practice Address - Fax:512-467-1101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2017-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111NR0400X
261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty
No111NR0400XChiropractic ProvidersChiropractorRehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX676659Medicare Oscar/Certification
TX0A3339Medicare PIN