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General NPI Number Information
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NPI Number | 1033426325
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Entity Type | Organization
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Legal Business Name | SAN JACINTO CLINIC & REHABILITATION LLC
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Dates
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Enumeration Date | 09/08/2010
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Last Update Date | 09/13/2010
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Provider Practice Location Address
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Address Line | 2802 SAN JACINTO ST
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City | HOUSTON
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State | TX
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Zip | 77004-2700
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Country | US
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Telephone | 713-654-4033
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Fax | 713-654-4036
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Provider Business Mailing Address
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Address Line | 2802 SAN JACINTO ST
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City | HOUSTON
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State | TX
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Zip | 77004-2700
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Country | US
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Telephone | 713-654-4033
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Fax | 713-654-4036
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Authorized Official
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Title or Position | MANAGER
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Name | BICHLIEN NGUYEN
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Credential |
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Telephone | 713-654-4033
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225CX0006X
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Taxonomy Name | Orientation and Mobility Training Rehabilitation Counselor
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License Number | J3173
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License Number State | TX
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