Provider Demographics
NPI:1336190289
Name:INPATIENT REHABILITATION SPECIALISTS PA
Entity Type:Organization
Organization Name:INPATIENT REHABILITATION SPECIALISTS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:K
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-566-7766
Mailing Address - Street 1:PO BOX 720999
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75372-0999
Mailing Address - Country:US
Mailing Address - Phone:214-345-7456
Mailing Address - Fax:214-345-4152
Practice Address - Street 1:1311 W PRESIDENT GEORGE BUSH HWY
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-1153
Practice Address - Country:US
Practice Address - Phone:214-345-7456
Practice Address - Fax:214-345-4152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX161160001Medicaid
TX161160001Medicaid
NVCB983AMedicare PIN
TXDB6257Medicare PIN
TX00619VMedicare PIN
TX00619VOtherBCBS