Organization
TS CARLSON PEDIATRIC REHAB LP
Active
Other names
HealthStar Pediatric Rehab
Organization subpart
No
Provider details
NPI number
Authorized official
MS. STACI LYN CARLSON SLP (OWNER/ADMINISTRATOR)
(915) 779-7827
Entity
Organization
Contact information
Practice address
6800 GATEWAY BLVD E, BLDG 4A, EL PASO, TX 79915-1040
(915) 779-7827
(915) 779-7829
Mailing address
6800 GATEWAY BLVD E, BLDG 4A, EL PASO, TX 79915-1040
(915) 779-7827
(915) 779-7829
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
295233501
—
TX
Enumeration date
12/13/2011
Last updated
08/19/2015
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