Basic Information
| Provider Information | |||||||||
| NPI: | 1780876730 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WARM SPRINGS REHABILITATION FOUNDATION, INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | VICTORIA WARM SPRINGS REHABILITATION HOSPITAL | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 909 NE LOOP 410 | ||||||||
| Address2: | SUITE 500 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782091302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2108290009 | ||||||||
| FaxNumber: | 2108298741 | ||||||||
| Practice Location | |||||||||
| Address1: | 102 MEDICAL DR | ||||||||
| Address2: | |||||||||
| City: | VICTORIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 779043101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3615766200 | ||||||||
| FaxNumber: | 3615729296 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2007 | ||||||||
| LastUpdateDate: | 04/01/2008 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | MULLER | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | CORPORATE CONTROLLER | ||||||||
| AuthorizedOfficialTelephone: | 2108322350 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | CPA | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 284300000X | Y | Hospitals | Special Hospital |
No ID Information.