Provider Demographics
NPI:1003127325
Name:CHIJIOKE OKOLI HENIX
Entity Type:Organization
Organization Name:CHIJIOKE OKOLI HENIX
Other - Org Name:DYNAMIC REHABILITATION SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:CHIJIOKE
Authorized Official - Last Name:HENIX
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-367-3418
Mailing Address - Street 1:3806 WESTALL LN
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-6261
Mailing Address - Country:US
Mailing Address - Phone:713-367-3418
Mailing Address - Fax:281-778-7846
Practice Address - Street 1:3806 WESTALL LN
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-6261
Practice Address - Country:US
Practice Address - Phone:713-367-3418
Practice Address - Fax:281-778-7846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00896K261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
000896KMedicare PIN