Provider Demographics
NPI:1871607671
Name:PRODUCTIVE REHABILITATION INSTITUTE OF DALLAS FOR ERGONOMICS
Entity type:Organization
Organization Name:PRODUCTIVE REHABILITATION INSTITUTE OF DALLAS FOR ERGONOMICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYER
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MPH
Authorized Official - Phone:214-351-6600
Mailing Address - Street 1:5701 MAPLE AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-6596
Mailing Address - Country:US
Mailing Address - Phone:214-351-6600
Mailing Address - Fax:214-351-5046
Practice Address - Street 1:5701 MAPLE AVE STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-6596
Practice Address - Country:US
Practice Address - Phone:214-351-6600
Practice Address - Fax:214-351-5046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)