Organization
TEMPLE MEMORIAL PEDIATRIC CENTER INC.
Active
Other names
Temple Memorial Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA K VARNER (CEO)
(903) 794-2705
Entity
Organization
Contact information
Practice address
1710 MOORES LN, TEXARKANA, TX 75503-1858
(903) 794-2705
(903) 793-1203
Mailing address
1710 MOORES LN, TEXARKANA, TX 75503-1858
(903) 794-2705
(903) 793-1203
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
009425
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T7468
BCBS OF TEXAS
TX
05
—
021289601
—
TX
05
—
116506742
—
AR
01
—
8P097
ARKANSAS BCBS
TX
Enumeration date
01/16/2007
Last updated
04/10/2024
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