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General NPI Number Information
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NPI Number | 1942664750
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Entity Type | Organization
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Legal Business Name | LYMPHEDEMA TREATMENT CENTERS OF AMERICA, INC.
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Dates
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Enumeration Date | 04/07/2016
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 1800 W 26TH ST 105
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City | HOUSTON
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State | TX
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Zip | 77008-1450
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Country | US
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Telephone | 713-862-9300
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20306
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City | HOUSTON
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State | TX
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Zip | 77225-0306
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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 | OFFICE MANAGER
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Name | JEFFREY VANZUYT
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Credential |
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Telephone | 713-526-7926
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 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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