1588902639 NPI number — THERAPY & BEYOND OF HOUSTON, LLC

Table of content: (NPI 1588902639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588902639 NPI number — THERAPY & BEYOND OF HOUSTON, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THERAPY & BEYOND OF HOUSTON, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1588902639
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3620 NORTH JOSEY LANE
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
CARROLLTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75007-3159
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-364-4654
Provider Business Mailing Address Fax Number:
888-237-2214

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9940 W SAM HOUSTON PKWY S
Provider Second Line Business Practice Location Address:
SUITE 320
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77099-5305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-364-4654
Provider Business Practice Location Address Fax Number:
888-237-2214
Provider Enumeration Date:
01/24/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CRONE
Authorized Official First Name:
SEAN
Authorized Official Middle Name:
Authorized Official Title or Position:
COO
Authorized Official Telephone Number:
469-892-7500

Provider Taxonomy Codes

  • Taxonomy code: 261QD1600X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 261QM0855X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)