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General NPI Number Information
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NPI Number | 1750147310
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Entity Type | Organization
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Legal Business Name | BRAIN AND SPINE REHAB SERVICES LLC
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Dates
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Enumeration Date | 02/22/2024
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 1313 LA CONCHA LN
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City | HOUSTON
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State | TX
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Zip | 77054-1809
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Country | US
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Telephone | 832-476-8036
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Fax |
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Provider Business Mailing Address
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Address Line | 1313 LA CONCHA LN
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City | HOUSTON
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State | TX
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Zip | 77054-1809
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Country | US
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Telephone | 832-476-8036
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AJAYKUMAR PATEL
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Credential | PT
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Telephone | 248-403-1730
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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