Provider Demographics
NPI:1629027693
Name:SUGAR LAND REHABILITATION HOSPITAL LP
Entity Type:Organization
Organization Name:SUGAR LAND REHABILITATION HOSPITAL LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:BRAXTON
Authorized Official - Last Name:NEIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:940-716-1673
Mailing Address - Street 1:1722 9TH ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-5003
Mailing Address - Country:US
Mailing Address - Phone:940-716-1673
Mailing Address - Fax:940-766-1077
Practice Address - Street 1:1325 HIGHWAY 6
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478
Practice Address - Country:US
Practice Address - Phone:281-276-7574
Practice Address - Fax:281-494-4950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX008445283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283X00000XHospitalsRehabilitation Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX453098Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER