Provider Demographics
NPI:1407914872
Name:THERAPY SPOT PLLC
Entity Type:Organization
Organization Name:THERAPY SPOT PLLC
Other - Org Name:THE THERAPY SPOT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:GERKE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-383-9700
Mailing Address - Street 1:8619 BROADWAY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8496
Mailing Address - Country:US
Mailing Address - Phone:281-485-4818
Mailing Address - Fax:281-485-5446
Practice Address - Street 1:8619 BROADWAY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8496
Practice Address - Country:US
Practice Address - Phone:281-485-4818
Practice Address - Fax:281-485-5446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2015-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX164781001Medicaid
TX3435197OtherAETNA