Provider Demographics
NPI:1104365402
Name:SUPERIOR REHAB CENTER
Entity Type:Organization
Organization Name:SUPERIOR REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DUY
Authorized Official - Middle Name:
Authorized Official - Last Name:BUI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-250-6996
Mailing Address - Street 1:14655 NORTHWEST FWY
Mailing Address - Street 2:STE 103
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77040-4042
Mailing Address - Country:US
Mailing Address - Phone:346-571-2933
Mailing Address - Fax:832-849-1922
Practice Address - Street 1:14655 NORTHWEST FWY
Practice Address - Street 2:STE 103
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77040-4042
Practice Address - Country:US
Practice Address - Phone:346-571-2933
Practice Address - Fax:832-849-1922
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8235111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty