Provider Demographics
NPI:1104409366
Name:PRESTIGE PHYSICAL THERAPY & REHAB, LLC
Entity type:Organization
Organization Name:PRESTIGE PHYSICAL THERAPY & REHAB, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:E
Authorized Official - Last Name:MENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-641-4490
Mailing Address - Street 1:556 W ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-6388
Mailing Address - Country:US
Mailing Address - Phone:956-641-4490
Mailing Address - Fax:956-641-4446
Practice Address - Street 1:556 W ELIZABETH ST STE B
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-6389
Practice Address - Country:US
Practice Address - Phone:956-641-4490
Practice Address - Fax:888-361-5571
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-04
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty