Organization
LISARA REHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SARA ELIZABETH YOUNG PTA (OWNER)
(210) 614-3003
Entity
Organization
Contact information
Practice address
7220 LOUIS PASTEUR DR STE 106, 4319 MEDICAL 131-113, SAN ANTONIO, TX 78229-4537
(210) 614-3003
(210) 692-7898
Mailing address
7220 LOUIS PASTEUR DR STE 106, 4319 MEDICAL 131-113, SAN ANTONIO, TX 78229-4537
(210) 614-3003
(210) 692-7898
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0019KX
BCBS GROUP NUMBER
TX
Enumeration date
08/04/2006
Last updated
08/22/2020
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