Provider Demographics
NPI:1073807079
Name:TERENA HEALTH AND REHABILITATION SERVICES
Entity Type:Organization
Organization Name:TERENA HEALTH AND REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:NNENNA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGOMUO
Authorized Official - Suffix:
Authorized Official - Credentials:MOT, OTR
Authorized Official - Phone:713-695-7455
Mailing Address - Street 1:4625 NORTH FWY
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-2914
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4625 NORTH FWY
Practice Address - Street 2:SUITE 203
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-2914
Practice Address - Country:US
Practice Address - Phone:713-695-7455
Practice Address - Fax:713-695-7456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108225225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty