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General NPI Number Information
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NPI Number | 1578104352
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Entity Type | Organization
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Legal Business Name | LYMPHEDEMA THERAPY SPECIALISTS INC.
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Dates
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Enumeration Date | 10/03/2019
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 2385 W BELLFORT AVE. STE 100
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City | HOUSTON
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State | TX
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Zip | 77054
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Country | US
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Telephone | 713-497-5335
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Fax | 833-891-3211
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Provider Business Mailing Address
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Address Line | 2385 W BELLFORT AVE. STE. 100
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City | HOUSTON
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State | TX
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Zip | 77054-5001
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Country | US
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Telephone | 713-497-5335
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Fax | 833-891-3211
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Authorized Official
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Title or Position | REVENUE CYCLE MANAGER
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Name | BENJAMIN GOMEZ
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Credential |
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Telephone | 832-930-9819
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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