Provider Demographics
NPI:1457392417
Name:TEAM CARE REHAB SERVICES INC
Entity Type:Organization
Organization Name:TEAM CARE REHAB SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:HUNTER
Authorized Official - Middle Name:HENDERSON GREGORY
Authorized Official - Last Name:HART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-691-0039
Mailing Address - Street 1:PO BOX 681655
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78268-1655
Mailing Address - Country:US
Mailing Address - Phone:210-691-0039
Mailing Address - Fax:210-699-0136
Practice Address - Street 1:9901 W IH 10 STE 615
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2246
Practice Address - Country:US
Practice Address - Phone:210-691-0039
Practice Address - Fax:210-699-0136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX654270000225100000X
TX551990000225X00000X
TX14529235Z00000X
TX14239235Z00000X
261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1004892Medicaid
TX159438402Medicaid
TX1004892Medicaid