Provider Demographics
NPI:1508570888
Name:BACKHAM LLC
Entity Type:Organization
Organization Name:BACKHAM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LY
Authorized Official - Middle Name:
Authorized Official - Last Name:BACKHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-452-7542
Mailing Address - Street 1:6515 HARCOURT BRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77084-2248
Mailing Address - Country:US
Mailing Address - Phone:832-452-7542
Mailing Address - Fax:
Practice Address - Street 1:6515 HARCOURT BRIDGE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-2248
Practice Address - Country:US
Practice Address - Phone:832-452-7542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational MedicineGroup - Multi-Specialty