Healthcare Provider Details

I. General information

NPI: 1770520371
Provider Name (Legal Business Name): VENTANA THERAPY CENTER LIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 01/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141S ROADRUNNER PKWY STE 111
LAS CRUCES NM
88011-2000
US

IV. Provider business mailing address

1300 W SAM HOUSTON PKWY S
HOUSTON TX
77042-2453
US

V. Phone/Fax

Practice location:
  • Phone: 505-532-8210
  • Fax: 505-532-8209
Mailing address:
  • Phone: 713-297-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNM

VIII. Authorized Official

Name: JANNA P. KING
Title or Position: VICE PRESIDENT OF LEGAL
Credential: JD
Phone: 713-297-7014