1922839935 NPI number — NEW LIFE BRACE AND LIMB, LLC

Table of content: (NPI 1922839935)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922839935 NPI number — NEW LIFE BRACE AND LIMB, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW LIFE BRACE AND LIMB, 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:
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NPI Number Information

NPI Number:
1922839935
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 BLOSSOM
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
WEBSTER
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77598
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-316-5805
Provider Business Mailing Address Fax Number:
281-316-5970

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10425 HUFFMEISTER ROAD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77065
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
346-809-3500
Provider Business Practice Location Address Fax Number:
346-809-3501
Provider Enumeration Date:
08/12/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BEVERLY
Authorized Official First Name:
CHRIS
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
713-440-7000

Provider Taxonomy Codes

  • Taxonomy code: 335E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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