Organization
M & D LEGACY
Active
Other names
Transformations Rehabilitation Services
Organization subpart
No
Provider details
NPI number
Authorized official
GIANNI BALLOU (CREDENTIALING COORDINATOR)
(915) 213-5490
Entity
Organization
Contact information
Practice address
9244 GATEWAY BLVD E STE A, EL PASO, TX 79907-1848
(915) 213-5490
(915) 213-3285
Mailing address
9244 GATEWAY BLVD E STE A, EL PASO, TX 79907-1848
(915) 213-5490
(915) 213-3285
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/06/2013
Last updated
09/24/2025
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