Provider Demographics
NPI:1972754224
Name:PRABETG INC
Entity type:Organization
Organization Name:PRABETG INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:ANDRA
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-464-6089
Mailing Address - Street 1:6292 MONTGOMERY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-3237
Mailing Address - Country:US
Mailing Address - Phone:210-464-6089
Mailing Address - Fax:210-590-7559
Practice Address - Street 1:6292 MONTGOMERY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-3237
Practice Address - Country:US
Practice Address - Phone:210-464-6089
Practice Address - Fax:210-590-7559
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCDANIELS PERSONAL CARE HOME
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121600310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility