NPIMap

Organization Active NPI

Optimum Rehabilitation LTD

  • Physical Therapist
  • Brenham, TX
National Provider Identifier
1669457842
Registry record updated Jun 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1026052 Issued in TX
Legal business name
OPTIMUM REHABILITATION LTD
Practice address
3120 Hwy 36 S
Brenham, TX 77833
Phone
(979) 277-9186
Fax
(979) 277-9924
NPI assigned
Dec 12, 2005
Last updated
Jun 6, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2008

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

Authorized official

Name
Ms. Virginia Yolanda Dabera
Title
Insurance Billing Specialist
Phone
(979) 277-9186

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 1026052 TX Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X 100446 TX

Addresses

Primary practice location

3120 Hwy 36 S
Brenham, TX 77833

Mailing address

3120 Hwy 36 S
Brenham, TX 77833
Phone (979) 277-9186

Other identifiers 1

IdentifierTypeStateIssuer
021688901MedicaidTX

National Provider Directory

National Provider Directory

Locations

3120 Highway 36 S
Brenham, TX 77833
Phone (979) 277-9186

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1134345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212710400000",
    "number": "1669457842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 HWY 36 S",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "77833",
            "telephone_number": "979-277-9186",
            "fax_number": "979-277-9924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 HWY 36 S",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "77833",
            "telephone_number": "979-277-9186",
            "fax_number": "979-277-9924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM REHABILITATION LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-12",
        "last_updated": "2008-06-06",
        "status": "A",
        "authorized_official_last_name": "DABERA",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_middle_name": "YOLANDA",
        "authorized_official_title_or_position": "INSURANCE BILLING SPECIALIST",
        "authorized_official_telephone_number": "979-277-9186",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1026052",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "TX",
            "license": "100446",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "021688901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2008; 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.