Healthcare Provider Details

I. General information

NPI: 1154144798
Provider Name (Legal Business Name): EPIC REHAB SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/04/2024
Last Update Date: 11/04/2024
Certification Date: 11/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 LONG REACH DR APT 11202
SUGAR LAND TX
77478-4197
US

IV. Provider business mailing address

2323 LONG REACH DR APT 11202
SUGAR LAND TX
77478-4197
US

V. Phone/Fax

Practice location:
  • Phone: 773-430-6608
  • Fax:
Mailing address:
  • Phone: 773-430-6608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. CHUKWUEMEKA KEVIN OKABUONYE
Title or Position: OCCUPATIONAL THERAPIST
Credential:
Phone: 773-430-6608