Provider Demographics
NPI:1720096308
Name:BROWNSVILLE REHABILITATION SERVICES, P.C.
Entity Type:Organization
Organization Name:BROWNSVILLE REHABILITATION SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:LUPITA
Authorized Official - Middle Name:
Authorized Official - Last Name:VARGAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-982-8907
Mailing Address - Street 1:PO BOX 5139
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78523-5139
Mailing Address - Country:US
Mailing Address - Phone:956-982-8907
Mailing Address - Fax:956-982-0436
Practice Address - Street 1:535 PAREDES LINE RD
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78521-2483
Practice Address - Country:US
Practice Address - Phone:956-982-8907
Practice Address - Fax:956-982-0436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-03
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1110880225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPT0010741Medicaid
P08695Medicare UPIN