Provider Demographics
NPI:1093830051
Name:ULTIMATE CHOICE MED & REHAB CLINIC, L.L.C.
Entity Type:Organization
Organization Name:ULTIMATE CHOICE MED & REHAB CLINIC, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARLA
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:RANDALL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-669-9395
Mailing Address - Street 1:PO BOX 88118
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77288-0118
Mailing Address - Country:US
Mailing Address - Phone:713-669-9395
Mailing Address - Fax:713-941-9801
Practice Address - Street 1:8533 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017
Practice Address - Country:US
Practice Address - Phone:713-669-9395
Practice Address - Fax:713-941-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2010-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty