Provider Demographics
NPI:1356679690
Name:FOXGATE INVESTMENTS LLC
Entity Type:Organization
Organization Name:FOXGATE INVESTMENTS LLC
Other - Org Name:PHYSICAL THERAPY & PAIN MANAGEMENT CENTER OF HOUSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MEHRDAD
Authorized Official - Middle Name:F
Authorized Official - Last Name:MAHDAVI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-782-4332
Mailing Address - Street 1:2605 POTOMAC DR STE 2
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4529
Mailing Address - Country:US
Mailing Address - Phone:713-782-4332
Mailing Address - Fax:713-784-1269
Practice Address - Street 1:2605 POTOMAC DR STE 2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-4529
Practice Address - Country:US
Practice Address - Phone:713-782-4332
Practice Address - Fax:713-784-1269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)