Provider Demographics
NPI:1619591021
Name:PELVIC HEALTH OF SOUTHEAST TEXAS PLLC
Entity Type:Organization
Organization Name:PELVIC HEALTH OF SOUTHEAST TEXAS PLLC
Other - Org Name:ELEVATE PELVIC HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FILES
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:409-332-4028
Mailing Address - Street 1:2600 STABLE GATE LN
Mailing Address - Street 2:
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77640-1499
Mailing Address - Country:US
Mailing Address - Phone:409-789-9070
Mailing Address - Fax:
Practice Address - Street 1:3560 DELAWARE ST STE 311
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-3060
Practice Address - Country:US
Practice Address - Phone:409-332-4028
Practice Address - Fax:409-207-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-01
Last Update Date:2022-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy