Pederson-Martinez PLLC
Organization Active NPI Comprehensive Outpatient Rehabilitation Facility (CORF) · Palmhurst, TX
NPI 1003045741 · NPPES record last updated Aug 9, 2013
Key facts
- NPI
- 1003045741
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X
- Legal business name
- PEDERSON-MARTINEZ PLLC
- Practice address
- 123 W. Mile 3 Rd
Ste a-103
Palmhurst, TX 78573 - Phone
- (956) 585-9889
- Fax
- (956) 585-9896
- NPI assigned
- Jul 2, 2009
- Organization subpart
- No
Authorized official
- Name
- Mr. Shane Marlon Pederson
- Title
- President/Physical Therapist
- Phone
- (956) 585-9889
Practitioners 1
-
Leslie Ann Hinojosa, COTA
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110620000288 | TX | Part a Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services | 3476749045 | Practice locations: Palmhurst, TX |
National Provider Directory
Locations
123 W Mile 3 Rd
#A103
Palmhurst, TX 78573
Phone (956) 585-9889
123 W Mile 3 Rd
Ste A103
Palmhurst, TX 78573
Phone (956) 585-9889
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Comprehensive Outpatient Rehabilitation Facility (CORF) | 261QR0401X | Yes |
Addresses
Primary practice location
123 W. Mile 3 Rd
Ste a-103
Palmhurst, TX 78573
Mailing address
123 W. Mile 3 Rd
Ste a-103
Palmhurst, TX 78573
Phone (956) 585-9889
Other names
- OPS Rehabilitation
Other providers in Palmhurst, TX
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- Tina F Mukete
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- Ops Rehabilitation
- Palmhurst Dental and Orthodontics PLLC
- Jessica Elizabeth Pederson
- Shane Marlon Pederson
- Pediatric Kids Land Clinic P.a.
- Helen Pena
- Crystal Perez
All providers in Palmhurst, TX · Comprehensive Outpatient Rehabilitation Facility (CORF) in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.