Provider Demographics
NPI:1235497322
Name:PAIN REHAB AND WELLNESS YOGA CENTER ,PLLC
Entity Type:Organization
Organization Name:PAIN REHAB AND WELLNESS YOGA CENTER ,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:NIMISHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHROFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-293-9849
Mailing Address - Street 1:706B W BEN WHITE BLVD
Mailing Address - Street 2:SUITE NUMBER:160B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7153
Mailing Address - Country:US
Mailing Address - Phone:512-293-9849
Mailing Address - Fax:888-316-7855
Practice Address - Street 1:706B W BEN WHITE BLVD
Practice Address - Street 2:SUITE NUMBER:160B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7153
Practice Address - Country:US
Practice Address - Phone:512-293-9849
Practice Address - Fax:888-316-7855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty