Provider Demographics
NPI:1922552074
Name:INNOVEE MEDICAL THERAPY LLC
Entity Type:Organization
Organization Name:INNOVEE MEDICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:AARON
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:MAKSYMOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-684-8317
Mailing Address - Street 1:2910 SEA CHANNEL DR
Mailing Address - Street 2:
Mailing Address - City:SEABROOK
Mailing Address - State:TX
Mailing Address - Zip Code:77586-1640
Mailing Address - Country:US
Mailing Address - Phone:281-684-8317
Mailing Address - Fax:281-715-5350
Practice Address - Street 1:15255 GULF FWY
Practice Address - Street 2:SUITE 103E
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-5365
Practice Address - Country:US
Practice Address - Phone:281-684-8317
Practice Address - Fax:281-715-5350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-06
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1001441332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies