Provider Demographics
NPI:1649473869
Name:RESSLER REHABILITATION LLC
Entity type:Organization
Organization Name:RESSLER REHABILITATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:RESSLER
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, LAT, ATC, CSCS
Authorized Official - Phone:936-556-1510
Mailing Address - Street 1:4635 NE STALLINGS DR STE 101
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1667
Mailing Address - Country:US
Mailing Address - Phone:936-622-0098
Mailing Address - Fax:888-552-2070
Practice Address - Street 1:4635 NE STALLINGS DR STE 101
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75965-1667
Practice Address - Country:US
Practice Address - Phone:936-622-0098
Practice Address - Fax:888-552-2070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5774970001332B00000X
TX651060000261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX169550402Medicaid
TX00921UMedicare PIN