Healthcare Provider Details

I. General information

NPI: 1609469469
Provider Name (Legal Business Name): BRAIN INJURY AND REHAB CENTERS OF TEXAS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2021
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 CORDES DR STE 150
SUGAR LAND TX
77479-1462
US

IV. Provider business mailing address

2655 CORDES DR STE 150
SUGAR LAND TX
77479-1462
US

V. Phone/Fax

Practice location:
  • Phone: 832-667-8132
  • Fax: 281-664-5899
Mailing address:
  • Phone: 832-667-8132
  • Fax: 281-664-5899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAHUL DHAWAN
Title or Position: CEO
Credential:
Phone: 832-882-6742