Provider Demographics
NPI:1912924846
Name:PRIMEROS PASOS LLC
Entity Type:Organization
Organization Name:PRIMEROS PASOS LLC
Other - Org Name:FIRST STEPS PEDIATRIC REHAB
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BELINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOLLINGER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-683-9339
Mailing Address - Street 1:4004 N JACKSON RD
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-4962
Mailing Address - Country:US
Mailing Address - Phone:956-683-9339
Mailing Address - Fax:956-683-9329
Practice Address - Street 1:4004 N JACKSON RD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-4962
Practice Address - Country:US
Practice Address - Phone:956-683-9339
Practice Address - Fax:956-683-9329
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0065NUOtherBCBS OF TEXAS
TX183568801Medicaid
TX0065NUOtherBCBS OF TEXAS