Provider Demographics
NPI:1649316746
Name:BULVERDE REHABILITATION & WELLNESS
Entity type:Organization
Organization Name:BULVERDE REHABILITATION & WELLNESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DARLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-980-4055
Mailing Address - Street 1:21200 STATE HIGHWAY 46 W
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-6793
Mailing Address - Country:US
Mailing Address - Phone:830-980-4055
Mailing Address - Fax:830-438-4085
Practice Address - Street 1:21200 STATE HIGHWAY 46 W
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-6793
Practice Address - Country:US
Practice Address - Phone:830-980-4055
Practice Address - Fax:830-438-4085
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0036EFOtherBCBS GROUP NUMBER
TX0036EFOtherBCBS GROUP NUMBER