Provider Demographics
NPI:1104249317
Name:REHAB PRO LP
Entity type:Organization
Organization Name:REHAB PRO LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOPER
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:903-839-3600
Mailing Address - Street 1:17521 US HIGHWAY 69 S STE 120
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-5376
Mailing Address - Country:US
Mailing Address - Phone:903-839-3600
Mailing Address - Fax:
Practice Address - Street 1:17521 US HIGHWAY 69 S STE 120
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-5376
Practice Address - Country:US
Practice Address - Phone:903-839-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-23
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility