ST. DAVID'S PHYSICAL MEDICINE AND REHABILITATION, PLLC (NPI# 1629209606) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629209606 |
| Entity Type | Organization |
| Organization Name | ST. DAVID'S PHYSICAL MEDICINE AND REHABILITATION, PLLC |
| Practice Address |
1015 E 32nd St Suite 306 Austin TX 78705-2707 |
| Mailing Address |
98 San Jacinto Blvd Suite 1800 Austin TX 78701-4082 |
| Practice Telephone | 5122361310 |
| Practice Fax Number | 5122366963 |
| Mailing Telephone | 5127089700 |
| Mailing Fax Number | 5124824191 |
| Enumeration Date | 2009-08-07 |
| Last Update Date | 2011-08-05 |
| Authorized Official Name | MR. JOHN REBOK (VICE PRESIDENT) |
| Authorized Official Telephone | 5127089700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081P0004X |
Physical Medicine & Rehabilitation Specialization: Spinal Cord Injury Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
1015 E 32ND ST SUITE 306 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78705-2707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538164306 | Charles Bruce Malone IIi | Orthopaedic Surgery | 1015 E 32nd St, Ste 101, Austin, TX 78705-2700 | 2005-06-16 |
| 1710413554 | Ditto Surgical, Pllc | Surgery | 1015 E 32nd St, Suite 216, Austin, TX 78705-2707 | 2017-05-11 |
| 1336546282 | Alexandra Dezell | Nurse Practitioner | 1015 E 32nd St, Ste 203, Austin, TX 78705-2707 | 2014-11-20 |
| 1386050094 | New U Plastic Surgery | Plastic Surgery | 1015 E 32nd St, Ste. 205, Austin, TX 78705-2707 | 2014-07-02 |
| 1033552864 | U Gadaria Md Facs Pa | Plastic Surgery | 1015 E 32nd St, Suite 208, Austin, TX 78705-2707 | 2013-04-11 |
| 1942544218 | Bridget Petrowsky | Physician Assistant | 1015 E 32nd St, Ste 411, Austin, TX 78705-2707 | 2012-11-26 |
| 1962753947 | Britney Dann Knowlton | Physician Assistant | 1015 E 32nd St, 300, Austin, TX 78705-2707 | 2012-10-01 |
| 1376838094 | Sarah Ray | Clinical Nurse Specialist | 1015 E 32nd St, Suite 508, Austin, TX 78705-2707 | 2011-06-10 |
| 1902110653 | Adrienne Kathleen Flack | Nurse Practitioner | 1015 E 32nd St, Suite 203, Austin, TX 78705-2707 | 2010-08-04 |
| 1174837827 | Linda Ann Guy | Nurse Practitioner | 1015 E 32nd St, Suite 203, Austin, TX 78705-2707 | 2010-08-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740894559 | Ben Aviel | Specialist/Technologist | 2501 Leon, Austin, TX 78705 | 2020-08-31 |
| 1700408739 | Julie Marie Dorland | Obstetrics & Gynecology | Ut Austin Dell Medical School Obgyn Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2020-05-13 |
| 1952941155 | Oluwakemi Yemi-ese | Counselor | 2717 Rio Grande Street, Austin, TX 78705 | 2020-01-15 |
| 1285272765 | Lisa K Wheeler | Counselor | 2520 Longivew Street, Suite 313, Austin, TX 78705 | 2019-12-16 |
| 1033767637 | Olivia May Neel | Specialist/Technologist | 620 West 24th Street, 208a, Austin, TX 78705 | 2019-08-28 |
| 1336795202 | Grace Evelyn Martin | Specialist/Technologist | University of Texas, 110 Inner Campus Drive, Austin, TX 78705 | 2019-08-15 |
| 1801450317 | Nicole Buchele | Obstetrics & Gynecology | Ut Austin Dell Medical School-obgyn, Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2019-04-30 |
| 1124502794 | Joan Margaret Carroll | Physician Assistant | 3000 N, I-35, Suite 600, Austin, TX 78705 | 2018-09-19 |
| 1841797636 | Corbin Anne Weaver | Obstetrics & Gynecology | Medical Park Tower, 1301 W. 38th St., Suite 705, Austin, TX 78705 | 2018-04-09 |
| 1740707892 | Christine Marie Falk | Specialist/Technologist | 2810 Hemphill Park, Apt 211, Austin, TX 78705 | 2017-08-29 |
| Find all providers in zip 78705 | ||||
| Taxonomy Code | 2081P0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Spinal Cord Injury Medicine |
| A physician who addresses the prevention, diagnosis, treatment and management of traumatic spinal cord injury and non-traumatic etiologies of spinal cord dysfunction by working in an interdisciplinary manner. Care is provided to patients of all ages on a lifelong basis and covers related medical, physical, psychological and vocational disabilities and complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. ACGME Accredited Residency Program Requirements: 1 year of training with 3-5 years in relevant specialty for a total of 4-6 years. ABMS Approved Subspecialty Certificate: (Physical Medicine and Rehabilitation) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710935093 | David K Harris | Physical Medicine & Rehabilitation | 7307 Creekbluff Dr, Austin, TX 78750-8203 | 2006-05-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598785164 | Sally Ann Holmes | Physical Medicine & Rehabilitation | 2002 Holcombe Blvd., Spinal Cord Injury Care Line (128), Houston, TX 77030 | 2006-07-19 |
| 1437617768 | Julie M Quinn | Physical Medicine & Rehabilitation | 504 Medical Center Blvd, Conroe, TX 77304-2808 | 2019-03-05 |
| 1609384213 | Pm&r Consultants, Pllc | Physical Medicine & Rehabilitation | 6441 Main St, Houston, TX 77030-1502 | 2018-01-17 |
| 1861931560 | Omni Spine Pain Management, Pllc | Physical Medicine & Rehabilitation | 4500 Hillcrest Rd, Suite 185, Frisco, TX 75035-5418 | 2017-02-15 |
| 1538477088 | Tanisha A Toaston Do Pa | Physical Medicine & Rehabilitation | 2304 Highway 121, Bedford, TX 76021-5985 | 2010-09-17 |
| 1316260979 | Center for Spine, Sports, and Rehabilitation | Physical Medicine & Rehabilitation | 2100 West Loop S, Houston, TX 77027-3515 | 2010-03-10 |
| 1881822674 | Joseph Benjamin Carlock | Physical Medicine & Rehabilitation | 4500 S Lancaster Rd, Dallas, TX 75216-7167 | 2009-06-30 |
| 1801076617 | Michelle B. Trbovich | Physical Medicine & Rehabilitation | 7400 Merton Minter St, San Antonio, TX 78229-4404 | 2007-11-08 |
| 1497953988 | David Back Clinic of America | Physical Medicine & Rehabilitation | 3800 Hulen St, #110, Fort Worth, TX 76107-7276 | 2007-07-05 |
| 1720282122 | David Back Clinic of America, Inc. | Physical Medicine & Rehabilitation | 7148 Trail Lake Dr, Fort Worth, TX 76123-1969 | 2007-06-12 |
| Find all providers with the same taxonomy | ||||
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| 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.