| Organization Name: | NACOGDOCHES REHABILITATION GROUP, INC |
| NPI Number: | 1164416988 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JEFFREY C CUEVAS (PRESIDENT) |
| Mailing Address: | 3205 N University Dr Suite M Nacogdoches |
| State: | TX US |
| Postal Code: | 759652683 |
| Phone Number: | 9365527044 |
| Fax Number: | 9365527050 |
| NPI Enumeration Date: | 09/08/2005 |
| NPI Last Update Date: | 03/05/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 1108322 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |