Provider Demographics
NPI:1831241603
Name:REHABILITATIVE MEDICINE ASSOCIATES
Entity type:Organization
Organization Name:REHABILITATIVE MEDICINE ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDY
Authorized Official - Middle Name:G
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-691-6029
Mailing Address - Street 1:8220 WALNUT HILL LN
Mailing Address - Street 2:SUITE 508
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4427
Mailing Address - Country:US
Mailing Address - Phone:214-691-6029
Mailing Address - Fax:214-373-6857
Practice Address - Street 1:8220 WALNUT HILL LN
Practice Address - Street 2:SUITE 508
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4427
Practice Address - Country:US
Practice Address - Phone:214-691-6029
Practice Address - Fax:214-373-6857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2016-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00840NOtherMEDICARE
TX1094088-02Medicaid