Provider Demographics
NPI:1508488206
Name:KATY HAND AND LYMPHEDEMA THERAPY CENTER LLC
Entity Type:Organization
Organization Name:KATY HAND AND LYMPHEDEMA THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:MYTHILI
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMACHANDRAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:815-245-0184
Mailing Address - Street 1:5310 BRIARCLIFF LN
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-1505
Mailing Address - Country:US
Mailing Address - Phone:815-245-0184
Mailing Address - Fax:
Practice Address - Street 1:5310 BRIARCLIFF LN
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-1505
Practice Address - Country:US
Practice Address - Phone:815-245-0184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty