Provider Demographics
NPI:1245587385
Name:AMAZON PEDIATRIC REHAB
Entity type:Organization
Organization Name:AMAZON PEDIATRIC REHAB
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:A
Authorized Official - Last Name:PEREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-460-8800
Mailing Address - Street 1:1600 N 8TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-2436
Mailing Address - Country:US
Mailing Address - Phone:956-630-0779
Mailing Address - Fax:956-630-0788
Practice Address - Street 1:1600 N 8TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-2436
Practice Address - Country:US
Practice Address - Phone:956-630-0779
Practice Address - Fax:956-630-0788
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-08
Last Update Date:2012-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty