Provider Demographics
NPI:1922477702
Name:MAIN STREET PHYSICAL THERAPY SOLUTIONS
Entity Type:Organization
Organization Name:MAIN STREET PHYSICAL THERAPY SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANASO
Authorized Official - Middle Name:
Authorized Official - Last Name:IGBANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-382-0380
Mailing Address - Street 1:10006 BISSONNET ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-7860
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10006 BISSONNET ST
Practice Address - Street 2:SUITE A
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-7860
Practice Address - Country:US
Practice Address - Phone:713-382-0380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)