Provider Demographics
NPI:1659819571
Name:SEED REHABILITATION INC
Entity Type:Organization
Organization Name:SEED REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:
Authorized Official - Last Name:PAYNE
Authorized Official - Suffix:
Authorized Official - Credentials:MS,CCC-SLP
Authorized Official - Phone:713-560-0168
Mailing Address - Street 1:535 E FERNHURST DR
Mailing Address - Street 2:329
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-1431
Mailing Address - Country:US
Mailing Address - Phone:713-560-0168
Mailing Address - Fax:
Practice Address - Street 1:535 E FERNHURST DR
Practice Address - Street 2:329
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1431
Practice Address - Country:US
Practice Address - Phone:713-560-0168
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-11
Last Update Date:2017-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105178235Z00000X
TX18821235Z00000X
TX101973235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1003008145Medicaid
TX1073829396Medicaid
TX1427286053Medicaid