Provider Demographics
NPI: | 1740855139 |
---|---|
Name: | PLEXUS INJURY CENTERS TX LLC |
Entity type: | Organization |
Organization Name: | PLEXUS INJURY CENTERS TX LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | |
Authorized Official - First Name: | TERESA |
Authorized Official - Middle Name: | ISABEL |
Authorized Official - Last Name: | FLORES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 832-466-5611 |
Mailing Address - Street 1: | 5900 BALCONES DR STE 100 |
Mailing Address - Street 2: | |
Mailing Address - City: | AUSTIN |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78731-4298 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 832-466-5611 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 2646 S LOOP W STE 104 |
Practice Address - Street 2: | |
Practice Address - City: | HOUSTON |
Practice Address - State: | TX |
Practice Address - Zip Code: | 77054-2677 |
Practice Address - Country: | US |
Practice Address - Phone: | 832-466-5611 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2021-05-26 |
Last Update Date: | 2021-05-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 246ZE0600X | Technologists, Technicians & Other Technical Service Providers | Specialist/Technologist, Other | Electroneurodiagnostic | Group - Multi-Specialty |