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General NPI Number Information
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NPI Number | 1437333655
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Entity Type | Organization
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Legal Business Name | GEZOND THERAPY SERVICES
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Dates
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Enumeration Date | 12/24/2007
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Last Update Date | 12/24/2007
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Provider Practice Location Address
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Address Line | 109 W TYLER ST STE E
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City | GILMER
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State | TX
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Zip | 75644-2239
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Country | US
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Telephone | 903-720-5216
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 EAST BROADWAY, STE.C PMB 504
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City | PEARLAND
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State | TX
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Zip | 77581
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Country | US
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Telephone |
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Fax | 866-782-4170
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Authorized Official
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Title or Position | VP OF OPERATIONS
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Name | PAMELA B HAILEY
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Credential | MA/CCC-SLP
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Telephone | 903-720-5216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 15836
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License Number State | TX
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