Provider Demographics
NPI:1356080154
Name:PARK PLACE THERAPY LLC
Entity Type:Organization
Organization Name:PARK PLACE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMNISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SAYEEDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KURLAWALA
Authorized Official - Suffix:
Authorized Official - Credentials:ADMINSTRATOR
Authorized Official - Phone:832-915-5543
Mailing Address - Street 1:8118 PARK PLACE BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77017-3035
Mailing Address - Country:US
Mailing Address - Phone:832-915-5543
Mailing Address - Fax:346-335-2890
Practice Address - Street 1:8118 PARK PLACE BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-3035
Practice Address - Country:US
Practice Address - Phone:832-915-5543
Practice Address - Fax:346-335-2890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-31
Last Update Date:2022-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty