Provider Demographics
NPI:1346867538
Name:HEALING BODYWORKS REHABILITATION LLC
Entity Type:Organization
Organization Name:HEALING BODYWORKS REHABILITATION LLC
Other - Org Name:HEALING BODYWORKS LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING STAFF
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-884-8012
Mailing Address - Street 1:21315 BRANCHPORT DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-5275
Mailing Address - Country:US
Mailing Address - Phone:832-443-9372
Mailing Address - Fax:281-861-0375
Practice Address - Street 1:21315 BRANCHPORT DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-5275
Practice Address - Country:US
Practice Address - Phone:832-443-9372
Practice Address - Fax:281-861-0375
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-03
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty