Provider Demographics
NPI:1912994831
Name:ERGONOMIC REHABILITATION OF HOUSTON, LLC
Entity Type:Organization
Organization Name:ERGONOMIC REHABILITATION OF HOUSTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:VINCENT
Authorized Official - Last Name:SOPHER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:281-821-4200
Mailing Address - Street 1:283 LOCKHAVEN DR
Mailing Address - Street 2:SUITE 315
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-5525
Mailing Address - Country:US
Mailing Address - Phone:281-821-4200
Mailing Address - Fax:281-821-4880
Practice Address - Street 1:283 LOCKHAVEN DR
Practice Address - Street 2:SUITE 315
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-5525
Practice Address - Country:US
Practice Address - Phone:281-821-4200
Practice Address - Fax:281-821-4880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11045032251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0031JCOtherBCBS GROUP PROV#
TX8T0170OtherBCBS INDIVIDUAL PROV#
TX00802VMedicare ID - Type UnspecifiedMEDICARE GROUP#
TX0031JCOtherBCBS GROUP PROV#