# ST. DAVID'S PHYSICAL MEDICINE AND REHABILITATION, PLLC

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

## Provider details

- **NPI number:** 1629209606
- **Authorized official:** MR. JOHN REBOK (VICE PRESIDENT)
- **Authorized official phone:** (512) 708-9700

## Contact information

- **Practice address:** 1015 E 32ND ST, SUITE 306, AUSTIN, TX 78705-2707
- **Practice address phone:** (512) 236-1310
- **Practice address fax:** (512) 236-6963
- **Mailing address:** 98 SAN JACINTO BLVD, SUITE 1800, AUSTIN, TX 78701-4082
- **Mailing address phone:** (512) 708-9700
- **Mailing address fax:** (512) 482-4191

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P0004X | Spinal Cord Injury Medicine Physician | — | NULL | Yes |
| 2081P0004X | Spinal Cord Injury Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/07/2009
- **Last updated:** 08/05/2011