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General NPI Number Information
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NPI Number | 1487458709
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Entity Type | Organization
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Legal Business Name | ELEVIVE REHABILITATION LLC
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Dates
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Enumeration Date | 04/03/2025
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Last Update Date | 04/03/2025
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Provider Practice Location Address
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Address Line | 1110 LAKEVIEW DR
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City | SUGAR LAND
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State | TX
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Zip | 77478-3378
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Country | US
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Telephone | 346-847-7025
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Fax |
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Provider Business Mailing Address
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Address Line | 17350 STATE HIGHWAY 249 STE 220
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City | HOUSTON
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State | TX
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Zip | 77064-1132
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Country | US
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Telephone | 346-847-7025
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REHABILITATION
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Name | MR. EUGENE REAMICO
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Credential |
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Telephone | 346-847-7025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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