Healthcare Provider Details

I. General information

NPI: 1982008942
Provider Name (Legal Business Name): PLEX WOODLANDS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2014
Last Update Date: 10/20/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2733 RAYFORD RD
SPRING TX
77386-1741
US

IV. Provider business mailing address

2733 RAYFORD RD
SPRING TX
77386-1741
US

V. Phone/Fax

Practice location:
  • Phone: 281-499-7539
  • Fax:
Mailing address:
  • Phone: 281-499-7539
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number1160378
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number9027
License Number StateTX

VIII. Authorized Official

Name: MINH THE LUU
Title or Position: DIREECTOR
Credential: D.C.
Phone: 281-804-9096