Healthcare Provider Details

I. General information

NPI: 1104098458
Provider Name (Legal Business Name): LAMPSTAND HEALTH & REHAB OF BRYAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 07/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 E 29TH ST
BRYAN TX
77802-1954
US

IV. Provider business mailing address

2723 SUMMER OAKS DR
BARTLETT TN
38134-2858
US

V. Phone/Fax

Practice location:
  • Phone: 979-822-6611
  • Fax: 979-822-6699
Mailing address:
  • Phone: 901-937-7994
  • Fax: 901-937-1516

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: CHRISTOPHER J MURPHY
Title or Position: PRESIDENT
Credential:
Phone: 901-937-7994