Provider Demographics
NPI:1508810680
Name:WINTER PEDIATRIC THERAPY LP
Entity Type:Organization
Organization Name:WINTER PEDIATRIC THERAPY LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RACHELE
Authorized Official - Middle Name:LEBLANC
Authorized Official - Last Name:RENFROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-822-0808
Mailing Address - Street 1:9900 WESTPARK DR
Mailing Address - Street 2:STE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-5277
Mailing Address - Country:US
Mailing Address - Phone:713-528-3030
Mailing Address - Fax:713-528-0442
Practice Address - Street 1:340 N SAM HOUSTON PKWY E
Practice Address - Street 2:STE199
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3325
Practice Address - Country:US
Practice Address - Phone:281-822-0808
Practice Address - Fax:281-822-0498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-21
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192775801Medicaid
TX676647Medicare Oscar/Certification