Organization
SOUTHWEST ABILENE REHAB, PA
Active
Parent organization
SOUTHWEST ABILENE REHAB
Other names
South Texas Spine and Rehab
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHWEST ABILENE REHAB
Authorized official
MRS. NAKIA SHAWNEE LONG (PRACTICE MANAGER)
(830) 313-2514
Entity
Organization
Contact information
Practice address
2435 N VETERANS BLVD STE A, EAGLE PASS, TX 78852-6483
(830) 776-5996
(830) 776-5992
Mailing address
342 CEDAR ST, ABILENE, TX 79601
(830) 776-5996
(830) 776-5992
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
5128
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217704001
—
TX
Enumeration date
02/24/2010
Last updated
03/16/2011
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