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Organization
REALIZATION REHAB
Active
Organization
REALIZATION REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL MICHAEL BUERGER OTR (OWNER)
(903) 534-9590
Entity
Organization
Contact information
Practice address
5505 REAGAN ST, TYLER, TX 75707-2047
(903) 534-9590
Mailing address
5505 REAGAN ST, TYLER, TX 75707-2047
(903) 534-9590
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D10440808
—
TX
Enumeration date
04/06/2010
Last updated
05/11/2010
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