# ROCKPORT THERAPY CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487169843
- **Authorized official:** LINCOLN WAYNE DAVIS PTA (REGISTERED AGENT)
- **Authorized official phone:** (361) 727-6141

## Contact information

- **Practice address:** 1004 E MAIN ST STE D, ROCKPORT, TX 78382-2610
- **Practice address phone:** (361) 389-8253
- **Mailing address:** 1004 E MAIN ST STE D, ROCKPORT, TX 78382-2610
- **Mailing address phone:** (361) 389-8253

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0401X | Comprehensive Outpatient Rehabilitation Facility (CORF) | — | NULL | Yes |

## Other

- **Enumeration date:** 12/07/2017
- **Last updated:** 01/31/2018