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Organization

DIAMOND REHABILITATION CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SAMUEL DE AVILA (ADMINISTRATOR)
(915) 778-1796
Entity
Organization

Contact information

Practice address
5721 E YANDELL DR, EL PASO, TX 79925-3350
(915) 778-1796
(915) 778-8150
Mailing address
5721 E YANDELL DR, EL PASO, TX 79925-3350
(915) 778-1796
(915) 778-8150

Taxonomy

Speciality
Code
Description
License number
State
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0072JW
BCBS OF TEXAS
Enumeration date
05/10/2006
Last updated
08/22/2020
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