Provider Demographics
NPI:1568636249
Name:LOTUS CARE AND REHAB CENTER
Entity Type:Organization
Organization Name:LOTUS CARE AND REHAB CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PHONG
Authorized Official - Middle Name:TRUNG
Authorized Official - Last Name:NGO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:832-606-5822
Mailing Address - Street 1:20047 UPLAND CREEK DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449
Mailing Address - Country:US
Mailing Address - Phone:832-606-5822
Mailing Address - Fax:281-550-3881
Practice Address - Street 1:20047 UPLAND CREEK DR
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449
Practice Address - Country:US
Practice Address - Phone:832-606-5822
Practice Address - Fax:281-550-3881
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHONG TRUNG NGO LOTUS CARE AND REHAB CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-15
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDC9633111N00000X, 111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No111NR0200XChiropractic ProvidersChiropractorRadiologyGroup - Multi-Specialty