Provider Demographics
NPI:1891148433
Name:GREATER HEIGHTS WELLNESS & REHAB, L.L.C.
Entity Type:Organization
Organization Name:GREATER HEIGHTS WELLNESS & REHAB, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEMETRIS
Authorized Official - Middle Name:PHOEBUS
Authorized Official - Last Name:XYDAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:713-292-8150
Mailing Address - Street 1:12218 JONES RD STE H
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-5268
Mailing Address - Country:US
Mailing Address - Phone:713-292-8150
Mailing Address - Fax:
Practice Address - Street 1:12218 JONES RD STE H
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-5268
Practice Address - Country:US
Practice Address - Phone:713-292-8150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6028111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty