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General NPI Number Information
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NPI Number | 1275719080
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Entity Type | Organization
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Legal Business Name | 290 PAIN & REHABILITATION CENTER
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Dates
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Enumeration Date | 01/11/2008
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Last Update Date | 09/14/2009
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Provider Practice Location Address
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Address Line | 10900 NORTHWEST FWY STE 115
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City | HOUSTON
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State | TX
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Zip | 77092-7309
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Country | US
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Telephone | 713-290-1881
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Fax | 713-290-1616
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Provider Business Mailing Address
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Address Line | 10900 NORTHWEST FWY STE 115
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City | HOUSTON
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State | TX
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Zip | 77092-7309
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Country | US
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Telephone | 713-290-1881
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Fax | 713-290-1616
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | THAO T HUYNH
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Credential | D.C.
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Telephone | 713-290-1881
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State | TX
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