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NPI Code Detail

MEDICARE: KEITH LACHANCE PT

MEDICARE: KEITH LACHANCE PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1241476TX

General Provider Information

NPI Number : 1649324633
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH LACHANCE PT
Provider Business Mailing Address
First Line : 1333 MOURSUND ST
Second Line :
City : HOUSTON
State : TX
Zip : 77030-3408
Country : US
Telephone Number : 713-383-5653
Fax Number :
Provider Business Practice Location Address
First Line : 1333 MOURSUND ST
Second Line :
City : HOUSTON
State : TX
Zip : 77030-3408
Country : US
Telephone Number : 713-383-5653
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2007
Last Update Date : 09/13/2020

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Directions to “ KEITH LACHANCE PT” Practice Location

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