| Direct Rehabmed | |
|
3110 Park Center Dr. Tyler TX 75701-9215 | |
| (903) 593-9999 | |
| (903) 526-4239 |
| Full Name | Direct Rehabmed |
|---|---|
| Speciality | Physical Medicine & Rehabilitation |
| Location | 3110 Park Center Dr., Tyler, Texas |
| Authorized Official Name and Position | Ritesh R Prasad (PARTNER) |
| Authorized Official Contact | 9035939999 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Direct Rehabmed P.o. Box 132929 Tyler TX 75713-2929 Ph: (903) 593-9999 | Direct Rehabmed 3110 Park Center Dr. Tyler TX 75701-9215 Ph: (903) 593-9999 |
| NPI Number | 1609810308 |
|---|---|
| Provider Enumeration Date | 06/15/2006 |
| Last Update Date | 06/20/2012 |
| Medicare PECOS PAC ID | 6103814306 |
|---|---|
| Medicare Enrollment ID | O20060206000473 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609810308 | NPI | - | NPPES |
| Provider Name | Brandon C Marrow |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447283320 PECOS PAC ID: 4486668829 Enrollment ID: I20060206000483 |
| Provider Name | Racheal A Cox |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1366525008 PECOS PAC ID: 9234451469 Enrollment ID: I20141125001550 |
| Provider Name | Shannon Moltz Pirtle |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1740760214 PECOS PAC ID: 7810303807 Enrollment ID: I20210317002516 |
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