Pediatric Rehabilitation of Texas, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1012458 Issued in TX

Legal business name

PEDIATRIC REHABILITATION OF TEXAS, INC.

Practice address

3195 Calder St
Ste 201
Beaumont, TX 77702-1425

Phone

(409) 833-4115

Fax

(409) 833-1626

NPI assigned

Jun 14, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Gary Kent Wilson, BSPT

Title

Physical Therapist

Phone

(409) 833-4115

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1366704355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3195 CALDER ST",
            "address_2": "STE 201",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021425",
            "telephone_number": "409-833-4115",
            "fax_number": "409-833-1626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3195 CALDER ST",
            "address_2": "STE 201",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021425",
            "telephone_number": "409-833-4115",
            "fax_number": "409-833-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC REHABILITATION OF TEXAS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-14",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "409-833-4115",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "BSPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "TX",
            "license": "1012458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Suzanne Peiler
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• Pelican Assisted Living LLC

• Physical Therapy Clinic/Center in Beaumont, TX
• Providers in Beaumont, TX by specialty
• Physical Therapy Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.