Provider Demographics
NPI:1275163826
Name:ACE RIO PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ACE RIO PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NITA
Authorized Official - Middle Name:
Authorized Official - Last Name:PANCHOLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-687-7494
Mailing Address - Street 1:3725 E LEAGUE CITY PKWY STE 120
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-7373
Mailing Address - Country:US
Mailing Address - Phone:281-845-4300
Mailing Address - Fax:832-779-8870
Practice Address - Street 1:3725 E LEAGUE CITY PKWY STE 120
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-7373
Practice Address - Country:US
Practice Address - Phone:281-845-4300
Practice Address - Fax:832-779-8870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty