Organization
RENAISSANCE OUTPATIENT REHABILITATION CENTER, LLC.
Active
Other names
Kids Korner at Renaissance
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE R CARRERAS M.D. (MANAGING PARTNER)
(956) 682-6900
Entity
Organization
Contact information
Practice address
910 E 8TH ST STE 7, WESLACO, TX 78596-4346
(956) 702-9882
(956) 702-9886
Mailing address
PO BOX 720157, MCALLEN, TX 78504-0157
(956) 682-6900
(956) 682-8445
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
227900000X
Registered Respiratory Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0018EX
BC/BS PROVIDER ID
TX
05
—
094397902
—
TX
Enumeration date
07/12/2005
Last updated
12/16/2014
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