Provider Demographics
NPI:1780138081
Name:EAGLE PASS REHABILITATION SERVICES
Entity type:Organization
Organization Name:EAGLE PASS REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MANUEL
Authorized Official - Middle Name:S
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-325-7270
Mailing Address - Street 1:2149 DEL RIO BLVD STE 203
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-3487
Mailing Address - Country:US
Mailing Address - Phone:830-325-7270
Mailing Address - Fax:844-826-2055
Practice Address - Street 1:2149 DEL RIO BLVD STE 203
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-3487
Practice Address - Country:US
Practice Address - Phone:830-325-7270
Practice Address - Fax:844-826-2055
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy