Healthcare Provider Details

I. General information

NPI: 1437333655
Provider Name (Legal Business Name): GEZOND THERAPY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/24/2007
Last Update Date: 12/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 W TYLER ST STE E
GILMER TX
75644-2239
US

IV. Provider business mailing address

2800 EAST BROADWAY, STE.C PMB 504
PEARLAND TX
77581
US

V. Phone/Fax

Practice location:
  • Phone: 903-720-5216
  • Fax:
Mailing address:
  • Phone:
  • Fax: 866-782-4170

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number15836
License Number StateTX

VIII. Authorized Official

Name: PAMELA B HAILEY
Title or Position: VP OF OPERATIONS
Credential: MA/CCC-SLP
Phone: 903-720-5216