Provider Demographics
NPI:1053616227
Name:CARDINAL REHAB SERVICES, INC.
Entity type:Organization
Organization Name:CARDINAL REHAB SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:817-770-7805
Mailing Address - Street 1:729 GRAPEVINE HWY
Mailing Address - Street 2:SUITE 387
Mailing Address - City:HURST
Mailing Address - State:TX
Mailing Address - Zip Code:76054-2805
Mailing Address - Country:US
Mailing Address - Phone:817-770-7805
Mailing Address - Fax:877-214-0565
Practice Address - Street 1:729 GRAPEVINE HWY
Practice Address - Street 2:SUITE 387
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-2805
Practice Address - Country:US
Practice Address - Phone:817-770-7805
Practice Address - Fax:877-214-0565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-20
Last Update Date:2013-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX531803363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Multi-Specialty