Provider Demographics
NPI:1720364516
Name:BURLEIGH HEALTH CENTER & REHAB PLLC
Entity Type:Organization
Organization Name:BURLEIGH HEALTH CENTER & REHAB PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-237-3331
Mailing Address - Street 1:9740 BARKER CYPRESS ROAD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433
Mailing Address - Country:US
Mailing Address - Phone:832-237-3331
Mailing Address - Fax:832-237-4638
Practice Address - Street 1:9740 BARKER CYPRESS RD STE 111
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-1974
Practice Address - Country:US
Practice Address - Phone:832-237-3331
Practice Address - Fax:832-237-4638
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-25
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX454874261QR0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3573842Medicaid