Provider Demographics
NPI:1538482112
Name:PHYSICAL MEDICINE AND REHABILITATION
Entity Type:Organization
Organization Name:PHYSICAL MEDICINE AND REHABILITATION
Other - Org Name:ADVANCED PAIN MANAGEMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:LANGELAND
Authorized Official - Suffix:I
Authorized Official - Credentials:DC
Authorized Official - Phone:281-354-4000
Mailing Address - Street 1:24141 HIGHWAY 59
Mailing Address - Street 2:SUITE C
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-6112
Mailing Address - Country:US
Mailing Address - Phone:281-354-4000
Mailing Address - Fax:281-354-8128
Practice Address - Street 1:24141 HIGHWAY 59
Practice Address - Street 2:SUITE C
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-6112
Practice Address - Country:US
Practice Address - Phone:281-354-4000
Practice Address - Fax:281-354-8128
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty