Provider Demographics
NPI:1063431211
Name:CHILDREN FIRST PEDIATRIC REHABILITATION, LLP
Entity type:Organization
Organization Name:CHILDREN FIRST PEDIATRIC REHABILITATION, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATION
Authorized Official - Prefix:MRS
Authorized Official - First Name:LETICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLAREAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:9566-891-0000
Mailing Address - Street 1:464 W HIDALGO AVE
Mailing Address - Street 2:
Mailing Address - City:RAYMONDVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78580-3529
Mailing Address - Country:US
Mailing Address - Phone:956-689-1000
Mailing Address - Fax:956-689-6026
Practice Address - Street 1:464 W HIDALGO AVE
Practice Address - Street 2:
Practice Address - City:RAYMONDVILLE
Practice Address - State:TX
Practice Address - Zip Code:78580-3529
Practice Address - Country:US
Practice Address - Phone:956-689-1000
Practice Address - Fax:956-689-6026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX953377 CHIPSOtherPEDIATRIC REHABILITATION
TX0064KXOtherPEDIATRIC REHABILITATION
TX676571Medicare ID - Type UnspecifiedPEDIATRIC REHABILITATION