PERMIAN BASIN REHABILITATION CENTER FOR CRIPPLED CHILDREN AND ADULTS NPI 1104958701

NPI Information

NPI: 1104958701
Provider Name: PERMIAN BASIN REHABILITATION CENTER FOR CRIPPLED CHILDREN AND ADULTS
Classification: Clinic/Center - 261QR0401X
Entity Type: Organization

Specialization: Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)

Address:
620 N ALLEGHANEY AVE
ODESSA, TX
ZIP 79761
Phone: (432) 332-8244
Get Directions

PERMIAN BASIN REHABILITATION CENTER FOR CRIPPLED CHILDREN AND ADULTS is a rehabilitation and comprehensive outpatient rehabilitation facility (corf) clinic center in Odessa, TX. PERMIAN BASIN REHABILITATION CENTER FOR CRIPPLED CHILDREN AND ADULTS NPI is 1104958701. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

620 N ALLEGHANEY AVE
ODESSA, TX
ZIP 79761-408
Phone: (432) 332-8244
Fax: (432) 580-7428

The provider's authorized official is John Wade Kuehler .
The authorized official title is Executive Director and has the following contact phone number (432) 332-8244.

The enumeration date for this NPI number is 3/9/2007 and was last updated on 12/13/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	225100000X	Physical Therapist		No
2	225X00000X	Occupational Therapist		No
3	231H00000X	Audiologist		No
4	235Z00000X	Speech-Language Pathologist		No
5	261QR0400X	Clinic/Center	Rehabilitation	No
6	261QR0401X	Clinic/Center	Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5589378	OTHER	TEXAS	AETNA BILLING NUM
2	094460501	MEDICAID	TEXAS
3	051CT	OTHER	TEXAS	BCBS GROUP NUMBER
4	456608	MEDICARE ID-TYPE UNSPECIFIED	TEXAS	PROVIDER NUMBER
5	531269	OTHER	TEXAS	BCBS HEARING AID ID NUM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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