Organization
LAGUNA MADRE REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDY LEE PLATTNER (ADMINISTRATOR/OWNER)
(956) 943-2248
Entity
Organization
Contact information
Practice address
1200 STATE HIGHWAY 100, STE 9, PORT ISABEL, TX 78578-2708
(956) 943-2248
(956) 943-4459
Mailing address
225 MESQUITE DRIVE, LAGUNA VISTA, TX 78578-2450
(956) 943-2248
(956) 943-4459
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178171801
—
TX
Enumeration date
09/21/2006
Last updated
08/21/2012
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