Provider Demographics
NPI:1679152607
Name:TEXAS BRAIN INSTITUTE LLC
Entity Type:Organization
Organization Name:TEXAS BRAIN INSTITUTE LLC
Other - Org Name:TBI
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEFANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:VELGOS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, MSC
Authorized Official - Phone:888-900-1824
Mailing Address - Street 1:6808 HORNWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-3608
Mailing Address - Country:US
Mailing Address - Phone:888-900-1824
Mailing Address - Fax:
Practice Address - Street 1:7205 FANNIN ST STE 110B
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-5000
Practice Address - Country:US
Practice Address - Phone:888-900-1824
Practice Address - Fax:713-779-3400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center