Provider Demographics
NPI:1598876971
Name:THE IMANI GROUP
Entity Type:Organization
Organization Name:THE IMANI GROUP
Other - Org Name:IMANI HEALTH ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:C
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-887-8992
Mailing Address - Street 1:6917 CULLEN BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77021-5009
Mailing Address - Country:US
Mailing Address - Phone:713-715-7000
Mailing Address - Fax:
Practice Address - Street 1:6917 CULLEN BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77021-5009
Practice Address - Country:US
Practice Address - Phone:713-715-7000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00369NMedicare ID - Type Unspecified