Provider Demographics
NPI:1679169247
Name:LAKSHMIBA LLC
Entity Type:Organization
Organization Name:LAKSHMIBA LLC
Other - Org Name:HEALTH CLUB AT TRAVIS PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHASHI
Authorized Official - Middle Name:M
Authorized Official - Last Name:PATIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-212-7767
Mailing Address - Street 1:2900 WESLAYAN ST STE 545
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5369
Mailing Address - Country:US
Mailing Address - Phone:281-940-9423
Mailing Address - Fax:713-969-4834
Practice Address - Street 1:1010 TRAVIS ST STE 800
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002-5928
Practice Address - Country:US
Practice Address - Phone:281-940-9423
Practice Address - Fax:713-969-4834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic TrainerGroup - Single Specialty