Healthcare Provider Details

I. General information

NPI: 1508037367
Provider Name (Legal Business Name): ADVANCED HEALTH & REHAB CENTER, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2008
Last Update Date: 01/09/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 FM 1960 BYPASS RD E SUITE 122
HUMBLE TX
77338-3934
US

IV. Provider business mailing address

1420 FM 1960 BYPASS RD E SUITE 122
HUMBLE TX
77338-3934
US

V. Phone/Fax

Practice location:
  • Phone: 281-540-2225
  • Fax: 281-540-2621
Mailing address:
  • Phone: 281-540-2225
  • Fax: 281-540-2621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. LAUREN L BAKER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 281-540-2225