DORA ROBERTS REHABILITATION CENTER , NPI 1760486708 — BIG SPRING (TX)

NPI 1760486708

14+ Years Experience Organization

DORA ROBERTS REHABILITATION CENTER

06.08.2005
PROVIDER ENUMERATION DATE
07.08.2007
LAST UPDATE DATE
1760486708
NPI NUMBER

About DORA ROBERTS REHABILITATION CENTER

DORA ROBERTS REHABILITATION CENTER is a provider established in BIG SPRING, TX. The NPI number of DORA ROBERTS REHABILITATION CENTER is 1760486708 and was assigned on 06.08.2005. The practitioners primary taxonomy code is: 261QR0400X TX .

Mailing address

  • City: BIG SPRING
  • State: TX
  • Postal code: 797202429
  • Phone: 4322673806
  • Fax: 4322673809
  • Address: 306 W 3RD ST

Primary Practice Address

  • Region : BIG SPRING, TX
  • NPI : 1760486708
  • Phone : 4322673806
  • Fax : 4322673809
  • Postalcode : 797202429
  • Address : 306 W 3RD ST

Additional identifiers

  • Identifier: 00L09G
  • Code / Type : 1 - other
  • Identifier state : TX
  • Identifier issuer: MEDICARE B

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Provider taxonomy - Clinic/Center

  • Taxonomy code: 261QR0400X
  • License state: TX

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

Contacts:

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  • DORA ROBERTS REHABILITATION CENTER
  • Address : 306 W 3RD ST
  • Region : BIG SPRING, TX
  • NPI : 1760486708
  • Phone : 4322673806
  • Fax : 4322673809
  • Postalcode : 797202429

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 4322673806
  • Title or position : EXECUTIVE DIRECTOR

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

Field Name Value
Provider First Line Business Practice Location Address306 W 3RD 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 Business Practice Location Address City NameBIG SPRING
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 Code797202429
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 Number4322673806
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number4322673809
The fax number associated with the location address of the provider being identified.
NPI1760486708
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1261QR0400X
Provider Enumeration Date06.08.2005
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated07.08.2007
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).
Provider Organization Name (Legal Business Name)DORA ROBERTS REHABILITATION CENTER
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 First Line Business Mailing Address306 W 3RD ST
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 Business Mailing Address City NameBIG SPRING
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 NameTX
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 Code797202429
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 Number4322673806
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".
Provider Business Mailing Address Fax Number4322673809
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NamePHILLIPS
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 NamePENNY
The first name of the authorized official
Authorized Official Title or PositionEXECUTIVE DIRECTOR
The title or position of the authorized official
Authorized Official Telephone Number4322673806
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
Provider License Number State Code 1TX
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.
Other Provider Identifier 100L09G
Other Provider Identifier #1
Other Provider Identifier Type 11
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1TX
Other Provider Identifier State #1
Other Provider Identifier Issuer 1MEDICARE B
Other Provider Identifier Issuer #1
X

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