MATRIX REHABILITATION-TEXAS, INC. , NPI 1053351437 — MATRIX REHABILITATION OF DEER PARK in DEER PARK (TX)

NPI 1053351437

13+ Years Experience Organization

MATRIX REHABILITATION-TEXAS, INC.

Other organization name: MATRIX REHABILITATION OF DEER PARK. Name type code: 3 - doing business as (d/b/ a) name.

06.07.2006
PROVIDER ENUMERATION DATE
10/29/2018
LAST UPDATE DATE
1053351437
NPI NUMBER

About MATRIX REHABILITATION-TEXAS, INC.

MATRIX REHABILITATION-TEXAS, INC. is a provider established in DEER PARK, TX. The NPI number of MATRIX REHABILITATION-TEXAS, INC. is 1053351437 and was assigned on 06.07.2006. The practitioners primary taxonomy code is: 261QR0400X .

Mailing address

  • City: MECHANICSBURG
  • State: PA
  • Postal code: 170554325
  • Phone: 7179721100
  • Address: 4714 GETTYSBURG RD
  • Address 2: LEGAL DEPARTMENT

Primary Practice Address

  • Region : DEER PARK, TX
  • NPI : 1053351437
  • Phone : 2814765800
  • Fax : 2814765801
  • Postalcode : 775366104
  • Address : 3710 CENTER ST SUITE 102

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QR0400X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • MATRIX REHABILITATION-TEXAS, INC.
  • Address : 3710 CENTER ST SUITE 102
  • Region : DEER PARK, TX
  • NPI : 1053351437
  • Phone : 2814765800
  • Fax : 2814765801
  • Postalcode : 775366104

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 7179721100
  • Title or position : VICE PRESIDENT AND SECRETARY

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address3710 CENTER ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 102
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameDEER PARK
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameTX
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code775366104
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2814765800
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2814765801
The fax number associated with the location address of the provider being identified.
NPI1053351437
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QR0400X
Provider Enumeration Date06.07.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated10/29/2018
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization SubpartN
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)MATRIX REHABILITATION-TEXAS, INC.
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameMATRIX REHABILITATION OF DEER PARK
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address4714 GETTYSBURG RD
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressLEGAL DEPARTMENT
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameMECHANICSBURG
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NamePA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code170554325
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number7179721100
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Authorized Official Last NameTARVIN
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameMICHAEL
The first name of the authorized official
Authorized Official Middle NameE
The middle name of the authorized official
Authorized Official Title or PositionVICE PRESIDENT AND SECRETARY
The title or position of the authorized official
Authorized Official Telephone Number7179721100
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1261QR0400X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Clinic/Center
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
X

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