Basic Information
| Provider Information | |||||||||
| NPI: | 1093155137 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RINCON | ||||||||
| FirstName: | LUIS | ||||||||
| MiddleName: | ALBERTO | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4700 SETON CENTER PKWY | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787595295 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124391000 | ||||||||
| FaxNumber: | 5124391081 | ||||||||
| Practice Location | |||||||||
| Address1: | 1701 W BEN WHITE BLVD | ||||||||
| Address2: | STE. 100B | ||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787047667 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5124391000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2013 | ||||||||
| LastUpdateDate: | 06/25/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 3114210 | TX | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.