Provider Demographics
NPI:1689164451
Name:GULF COAST THERAPY HOUSTON LLC
Entity Type:Organization
Organization Name:GULF COAST THERAPY HOUSTON LLC
Other - Org Name:MILESTONES THERAPY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARIEL
Authorized Official - Middle Name:ALEXANDRA
Authorized Official - Last Name:TREVINO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-904-3444
Mailing Address - Street 1:6201 BONHOMME RD SUITE #462N
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-4473
Mailing Address - Country:US
Mailing Address - Phone:713-904-3444
Mailing Address - Fax:281-476-6388
Practice Address - Street 1:6201 BONHOMME RD STE 462N
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2869
Practice Address - Country:US
Practice Address - Phone:713-904-3444
Practice Address - Fax:281-476-6388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-16
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX018847OtherHOME HEALTH LICENSE