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General NPI Number Information
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NPI Number | 1164726592
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Entity Type | Organization
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Legal Business Name | SEALY PHYSICAL REHAB, LLC
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Dates
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Enumeration Date | 12/28/2010
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Last Update Date | 12/28/2010
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Provider Practice Location Address
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Address Line | 511 6TH ST
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City | SEALY
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State | TX
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Zip | 77474-2629
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Country | US
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Telephone | 979-877-0871
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Fax | 979-877-0582
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Provider Business Mailing Address
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Address Line | 511 6TH ST
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City | SEALY
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State | TX
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Zip | 77474-2629
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Country | US
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Telephone | 979-877-0871
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Fax | 979-877-0582
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. CHARLES EVERETT BECHTEL
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Credential | PHYSICAL THERAPIST
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Telephone | 979-877-0871
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1993409
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License Number State | TX
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