Healthcare Provider Details

I. General information

NPI: 1114453453
Provider Name (Legal Business Name): APOLLO REHAB AT WOODLANDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2017
Last Update Date: 05/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24854 CATHEDRAL LAKES PKWY
SPRING TX
77386
US

IV. Provider business mailing address

6125 LUTHER LN # 309
DALLAS TX
75225-6202
US

V. Phone/Fax

Practice location:
  • Phone: 707-666-3490
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: ARCHANA THOTA
Title or Position: PRESIDENT
Credential:
Phone: 707-666-3490