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General NPI Number Information
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NPI Number | 1962647354
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Entity Type | Organization
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Legal Business Name | BODYTEST
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Dates
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Enumeration Date | 12/12/2008
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 440 RAYFORD RD SUITE 125
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City | SPRING
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State | TX
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Zip | 77386-4168
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Country | US
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Telephone | 281-719-0401
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Fax |
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Provider Business Mailing Address
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Address Line | 2211 RAYFORD RD SUITE 111, BOX 131
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City | SPRING
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State | TX
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Zip | 77386-1555
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Country | US
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Telephone | 281-719-0401
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. LARS OOMS
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Credential | PT
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Telephone | 281-719-0401
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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 | MDH6938
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 1140655
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 293D00000X
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Taxonomy Name | Physiological Laboratory
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License Number |
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License Number State |
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