Provider Demographics
NPI:1396809158
Name:ACCESS REHAB & MOBILITY LLC
Entity type:Organization
Organization Name:ACCESS REHAB & MOBILITY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCIO
Authorized Official - Middle Name:
Authorized Official - Last Name:VILLARREAL
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:361-857-8002
Mailing Address - Street 1:4531 AYERS ST
Mailing Address - Street 2:SUITE 304
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415
Mailing Address - Country:US
Mailing Address - Phone:361-857-8002
Mailing Address - Fax:361-857-5028
Practice Address - Street 1:4531 AYERS ST
Practice Address - Street 2:SUITE 304
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415
Practice Address - Country:US
Practice Address - Phone:361-857-8002
Practice Address - Fax:361-857-5028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2013-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX175838502Medicaid
TX175838502Medicaid