Provider Demographics
NPI:1225763782
Name:KEE BODY BAR LLC
Entity Type:Organization
Organization Name:KEE BODY BAR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHLEBOTOMIST/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BACKMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-901-1527
Mailing Address - Street 1:11427 SABO RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-2501
Mailing Address - Country:US
Mailing Address - Phone:832-901-1527
Mailing Address - Fax:
Practice Address - Street 1:1506 BROADWAY ST STE 105
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5837
Practice Address - Country:US
Practice Address - Phone:832-901-1527
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2022-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomyGroup - Single Specialty