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NPI 1811640337

NPI 1811640337 : LEGION PHYSICAL THERAPY : HOUSTON, TX

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General NPI Number Information
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    NPI Number           |    1811640337
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    Entity Type          |    Organization 
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    Legal Business Name  |    LEGION PHYSICAL THERAPY 
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Dates
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    Enumeration Date     |    02/03/2022
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    Last Update Date     |    02/03/2022
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Provider Practice Location Address
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    Address Line         |    5317 FAYETTE ST 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77056-5928
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    Country              |    US
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    Telephone            |    832-800-3437
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    5317 FAYETTE ST 
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    City                 |    HOUSTON
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    State                |    TX
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    Zip                  |    77056-5928
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     ANDREW  HEIDEBRECHT 
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    Credential           |    
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    Telephone            |    832-800-3437
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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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