Provider Demographics
NPI:1982100129
Name:KMA REHABILITATION AND WELLNESS CENTER, INC.
Entity Type:Organization
Organization Name:KMA REHABILITATION AND WELLNESS CENTER, INC.
Other - Org Name:KMA HEALTH AND WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BIANCA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-861-0919
Mailing Address - Street 1:15821 FM 529 RD STE 327
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77095-2503
Mailing Address - Country:US
Mailing Address - Phone:281-861-0919
Mailing Address - Fax:
Practice Address - Street 1:16103 W LITTLE YORK RD STE E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084-6867
Practice Address - Country:US
Practice Address - Phone:832-964-7261
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-05
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitationGroup - Multi-Specialty