Provider Demographics
NPI:1720401433
Name:RITA S. GLAUDE, INC.
Entity Type:Organization
Organization Name:RITA S. GLAUDE, INC.
Other - Org Name:DIAGNOSTIC PAIN MANAGEMENT & REHAB. CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:RITA
Authorized Official - Middle Name:S
Authorized Official - Last Name:GLAUDE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-238-0303
Mailing Address - Street 1:117 LANE DR
Mailing Address - Street 2:SUITE 20
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471-2200
Mailing Address - Country:US
Mailing Address - Phone:281-238-0303
Mailing Address - Fax:281-238-0371
Practice Address - Street 1:117 LANE DR
Practice Address - Street 2:SUITE 20
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2200
Practice Address - Country:US
Practice Address - Phone:281-238-0303
Practice Address - Fax:281-238-0371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-31
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0019XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPhysical RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159569601Medicaid
TX159569601Medicaid