Provider Demographics
NPI:1356493092
Name:PAK REHABILITATION SERVICES
Entity Type:Organization
Organization Name:PAK REHABILITATION SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:TRUC
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:281-221-8018
Mailing Address - Street 1:2713 FERNDALE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-1113
Mailing Address - Country:US
Mailing Address - Phone:281-221-8018
Mailing Address - Fax:713-522-9399
Practice Address - Street 1:2713 FERNDALE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-1113
Practice Address - Country:US
Practice Address - Phone:281-221-8018
Practice Address - Fax:713-522-9399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100456261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation