Provider Demographics
NPI:1457518664
Name:HANDS ON SCHOOL OF MASSAGE OF BEAUMONT, LLC
Entity Type:Organization
Organization Name:HANDS ON SCHOOL OF MASSAGE OF BEAUMONT, LLC
Other - Org Name:OPTIMUM PERFORMANCE PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:BURKE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:409-866-8911
Mailing Address - Street 1:1214 N MAJOR DR
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-4003
Mailing Address - Country:US
Mailing Address - Phone:409-866-8911
Mailing Address - Fax:409-866-8962
Practice Address - Street 1:1214 N MAJOR DR
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-4003
Practice Address - Country:US
Practice Address - Phone:409-866-8911
Practice Address - Fax:409-866-8962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1166369261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy