1609960442 NPI number — LUCASVILLE PHYSICAL THERAPY LP

Table of content: (NPI 1609960442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609960442 NPI number — LUCASVILLE PHYSICAL THERAPY LP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LUCASVILLE PHYSICAL THERAPY LP
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:
6
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:
1609960442
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1300 W SAM HOUSTON PKWY S
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77042-2447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-297-7000
Provider Business Mailing Address Fax Number:
713-297-7090

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8046 OHIO RIVER RD
Provider Second Line Business Practice Location Address:
SUITE D
Provider Business Practice Location Address City Name:
WHEELERSBURG
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45694-1690
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
740-574-4433
Provider Business Practice Location Address Fax Number:
740-574-4765
Provider Enumeration Date:
10/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KING
Authorized Official First Name:
JANNA
Authorized Official Middle Name:
P.
Authorized Official Title or Position:
VP/AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
713-297-7000

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com