Provider Demographics
NPI:1689997108
Name:CSSARE PT GALLERIA LLC
Entity Type:Organization
Organization Name:CSSARE PT GALLERIA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENOY
Authorized Official - Middle Name:
Authorized Official - Last Name:BENNY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-798-4495
Mailing Address - Street 1:2100 WEST LOOP S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3515
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2100 WEST LOOP S
Practice Address - Street 2:SUITE 100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3515
Practice Address - Country:US
Practice Address - Phone:281-782-5360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CSSARE PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy