EAGLE'S TRACE INC NPI 1174601447

NPI Information

NPI: 1174601447
Provider Name: EAGLE'S TRACE INC

Doing Business As: OUTPATIENT REHABILITATION AGENCY AT EAGLE'S TRACE

Classification: Clinic/Center - 261QR0400X
Entity Type: Organization

Specialization: Rehabilitation

Address:
14703 EAGLE VISTA DRIVE
ATTN: REHABILITATION MGR
HOUSTON, TX
ZIP 77077
Phone: (281) 249-7000
Get Directions

EAGLE'S TRACE INC is a rehabilitation clinic center in Houston, TX. EAGLE'S TRACE INC NPI is 1174601447. The provider is registered as an organization entity type.
The provider Is Doing Business As Outpatient Rehabilitation Agency At Eagle's Trace.

The provider's business location address is:

14703 EAGLE VISTA DRIVE
ATTN: REHABILITATION MGR
HOUSTON, TX
ZIP 77077-394
Phone: (281) 249-7000
Fax: (410) 204-7237

The provider's authorized official is James K Walter .
The authorized official title is Finance Director and has the following contact phone number (410) 402-2315.

The enumeration date for this NPI number is 11/2/2006 and was last updated on 6/20/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR0400X	Clinic/Center	Rehabilitation	660930000	TEXAS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	676658	MEDICARE OSCAR/CERTIFICATION	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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