Provider Demographics
NPI:1447823356
Name:WEST TEXAS REHABILITATION SERVICES, LLC
Entity type:Organization
Organization Name:WEST TEXAS REHABILITATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:
Authorized Official - Last Name:BICOL
Authorized Official - Suffix:JR
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:575-300-9787
Mailing Address - Street 1:PO BOX 8188
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88202-8188
Mailing Address - Country:US
Mailing Address - Phone:575-300-9787
Mailing Address - Fax:
Practice Address - Street 1:200 W 1ST ST STE 100
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-4672
Practice Address - Country:US
Practice Address - Phone:575-840-3879
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty