Provider Demographics
NPI:1912939414
Name:LIBERTY REHABILITATION SPECIALISTS INC
Entity type:Organization
Organization Name:LIBERTY REHABILITATION SPECIALISTS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CARMEN
Authorized Official - Middle Name:NOEMI
Authorized Official - Last Name:CASTILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-798-1040
Mailing Address - Street 1:2130 NE LOOP 410 STE 212
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-4662
Mailing Address - Country:US
Mailing Address - Phone:210-656-5848
Mailing Address - Fax:210-656-5847
Practice Address - Street 1:2130 NE LOOP 410 STE 212
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-4662
Practice Address - Country:US
Practice Address - Phone:210-656-5848
Practice Address - Fax:210-656-5847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-06
Last Update Date:2025-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHandGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00186SMedicare PIN
TX5380570002Medicare NSC