Provider Demographics
NPI:1265552673
Name:ROUND ROCK REHAB, PC
Entity type:Organization
Organization Name:ROUND ROCK REHAB, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:H
Authorized Official - Last Name:THORNE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:512-388-1448
Mailing Address - Street 1:PO BOX 1169
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78680-1169
Mailing Address - Country:US
Mailing Address - Phone:512-388-1448
Mailing Address - Fax:512-388-7854
Practice Address - Street 1:16020 PARK VALLEY DR.
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-3573
Practice Address - Country:US
Practice Address - Phone:512-388-1448
Practice Address - Fax:512-388-7854
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty