Provider Demographics
NPI: | 1174882278 |
---|---|
Name: | LAYFIELD MEDICAL SOLUTIONS, PLLC |
Entity type: | Organization |
Organization Name: | LAYFIELD MEDICAL SOLUTIONS, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | DAVID |
Authorized Official - Middle Name: | EDWARDS |
Authorized Official - Last Name: | LAYFIELD |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | OTR |
Authorized Official - Phone: | 713-208-1118 |
Mailing Address - Street 1: | 2210 SILVER SAGE DR |
Mailing Address - Street 2: | |
Mailing Address - City: | HOUSTON |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 77077-6131 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 713-208-1118 |
Mailing Address - Fax: | 281-759-0074 |
Practice Address - Street 1: | 2210 SILVER SAGE DR |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77077-6131 |
Practice Address - Country: | US |
Practice Address - Phone: | 713-208-1118 |
Practice Address - Fax: | 281-759-0074 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2012-05-09 |
Last Update Date: | 2012-05-09 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 109789 | 225X00000X, 225XE0001X, 225XF0002X, 225XL0004X, 225XN1300X, 225XP0019X, 225XP0200X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225XP0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Pediatrics | Group - Single Specialty |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Single Specialty | |
No | 225XE0001X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Environmental Modification | Group - Single Specialty |
No | 225XF0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Feeding, Eating & Swallowing | Group - Single Specialty |
No | 225XL0004X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Low Vision | Group - Single Specialty |
No | 225XN1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Neurorehabilitation | Group - Single Specialty |
No | 225XP0019X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Physical Rehabilitation | Group - Single Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
TX | 140563101 | Medicaid | |
TX | 659989 | Other | BLUE CROSS BLUE SHIELD OF TEXAS |
TX | 502789091 | Other | TRICARE |