CUSTOM REHAB OF SOUTH TEXAS, INC. (NPI# 1700930633) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700930633 |
| Entity Type | Organization |
| Organization Name | CUSTOM REHAB OF SOUTH TEXAS, INC. |
| Practice Address |
12907 Highway 36 Needville TX 77461 |
| Mailing Address |
Po Box 467 Needville TX 77461-0467 |
| Practice Telephone | 9797937570 |
| Practice Fax Number | 9797935540 |
| Mailing Telephone | 9797937570 |
| Mailing Fax Number | 9797935540 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2011-07-07 |
| Authorized Official Name | MRS. LORENA MATTHIESEN (PRESIDENT) |
| Authorized Official Telephone | 9797937570 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 332BC3200X |
Durable Medical Equipment & Medical Supplies Specialization: Customized Equipment |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 010008301 | 05 | |
| TX | AMERIGROUP PROVIDER # | 10023796 | 01 |
| TX | 011390401 | 05 | |
| TX | BLUE CROSS BLUE SHIELD | 519066 | 01 |
| Street Address |
12907 HIGHWAY 36 |
| City | NEEDVILLE |
| State | TX |
| Zip Code | 77461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154618866 | Daniel Raymond Matthiesen | Technician, Other | 12907 Highway 36, Needville, TX 77461 | 2011-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538695218 | Janees Caregivers | Home Health | 8708 West 1st Street, Needville, TX 77461 | 2017-05-02 |
| 1558747550 | Kimberly Ullmann | Community Health Worker | 8611 Main Street, Needville, TX 77461 | 2015-08-03 |
| 1912057225 | South Texas Medical Clinics, P.a. | General Practice | 3006 School St., Needville, TX 77461 | 2007-01-11 |
| 1669569166 | Road Runner Ems | Ambulance | 14930 Dipple Lehman, Needville, TX 77461 | 2006-10-06 |
| 1790890994 | Lifechek Rosenberg LLC | Pharmacy | 13500 Hwy 36, Needville, TX 77461 | 2006-08-20 |
| 1629690896 | Kyla Celeste Mittanck | Pharmacist | 13500 Hwy 36, Needville, TX 77461 | 2020-05-11 |
| 1881192185 | Pharm House Needville, LLC. | Pharmacy | 13500 Hwy 36, Needville, TX 77461 | 2018-02-01 |
| 1215030200 | Obence Perez | Home Health | 3119 School Road, Needville, TX 77461-0414 | 2006-09-06 |
| 1932226354 | Wayne . Ley | Dentist | 8717 Main, Needville, TX 77461-0955 | 2007-03-22 |
| 1467828251 | Laura Valdez | Community/Behavioral Health | 8729 Garrett St, Needville, TX 77461-1721 | 2015-08-14 |
| Find all providers in zip 77461 | ||||
| Taxonomy Code | 332BC3200X |
| Grouping | Suppliers |
| Classification | Durable Medical Equipment & Medical Supplies |
| Specialization | Customized Equipment |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851990055 | Tatiana E Price | Durable Medical Equipment & Medical Supplies | 14406 Brunswick Place Dr, Houston, TX 77047-4645 | 2020-10-20 |
| 1497360911 | Sleep Better Austin Treatment Pllc | Durable Medical Equipment & Medical Supplies | 920 N Vista Ridge Blvd Ste 700, Cedar Park, TX 78613-7637 | 2020-09-11 |
| 1619586500 | National Seating & Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 12402 Slide Rd Ste 305, Lubbock, TX 79424-8322 | 2020-07-27 |
| 1508474396 | National Seating & Mobility, Inc. | Durable Medical Equipment & Medical Supplies | 4103 Kramer Ln Ste 201, Texarkana, TX 75501-8113 | 2020-07-17 |
| 1649896119 | Evolve Medical Supply & Equipment, LLC | Durable Medical Equipment & Medical Supplies | 4953 N. O'connor Rd., Suite 150, Irving, TX 75062 | 2020-06-22 |
| 1639794621 | Allen E Navey Dds Pa | Durable Medical Equipment & Medical Supplies | 405 W Gramercy Pl, San Antonio, TX 78212-2827 | 2020-06-15 |
| 1790309383 | Krishe Inc | Durable Medical Equipment & Medical Supplies | 7777 Warren Pkwy Ste 280, Frisco, TX 75034-8129 | 2020-05-30 |
| 1740800176 | Dme-now, LLC | Durable Medical Equipment & Medical Supplies | 734 S Saginaw Blvd, Saginaw, TX 76179-2109 | 2020-04-27 |
| 1336778737 | Paulette Sanford Dds, Pllc | Durable Medical Equipment & Medical Supplies | 4221 Benner Ste 200, Kyle, TX 78640-2221 | 2020-04-07 |
| 1962040303 | Sleep Better Austin Treatment Pllc | Durable Medical Equipment & Medical Supplies | 1600 W 38th St Ste 407, Austin, TX 78731-6407 | 2019-12-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on CUSTOM REHAB OF SOUTH TEXAS, INC..
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.