Provider Demographics
NPI:1861829863
Name:CENTER FOR SPINE, SPORTS AND REHABILITATION EXCELLENCE
Entity Type:Organization
Organization Name:CENTER FOR SPINE, SPORTS AND REHABILITATION EXCELLENCE
Other - Org Name:THE SPINE AND SPORTS CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BENOY
Authorized Official - Middle Name:V
Authorized Official - Last Name:BENNY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-590-2700
Mailing Address - Street 1:1111 HIGHWAY 6 STE 145
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4960
Mailing Address - Country:US
Mailing Address - Phone:713-590-2700
Mailing Address - Fax:713-590-2702
Practice Address - Street 1:1111 HIGHWAY 6
Practice Address - Street 2:SUITE 145
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4914
Practice Address - Country:US
Practice Address - Phone:713-590-2700
Practice Address - Fax:713-590-2702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-04
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty
No261Q00000XAmbulatory Health Care FacilitiesClinic/CenterGroup - Single Specialty