Organization
REAVIS REHAB & WELLNESS CENTER, INC.
Active
Other names
Reavis Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
CHARISE BOONE (EXECUTIVE DIRECTOR)
(512) 310-7665
Entity
Organization
Contact information
Practice address
1201 S IH 35, STE 105, ROUND ROCK, TX 78664-6615
(512) 310-7665
(512) 310-9228
Mailing address
1201 S IH 35, STE 105, ROUND ROCK, TX 78664-6615
(512) 310-7665
(512) 310-9228
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
611620000
TX
261QR0400X
Rehabilitation Clinic/Center
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031DG
BLUE CROSS BLUE SHIELD TX
TX
05
—
094474602
—
TX
Enumeration date
07/31/2006
Last updated
03/07/2016
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