EAGLE'S TRACE INC NPI 1174601447

NPI Information

  • NPI: 1174601447
  • Provider Name: EAGLE'S TRACE INC
  • Classification: Clinic/Center - 261QR0400X
  • Specialization: Rehabilitation
  • Entity Type: Organization
  • Doing Business As: OUTPATIENT REHABILITATION AGENCY AT EAGLE'S TRACE
  • Address: 14703 EAGLE VISTA DRIVE
    ATTN: REHABILITATION MGR
    HOUSTON, TX
    ZIP 77077
  • Phone: (281) 249-7000

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NPI Details

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
1261QR0400XClinic/CenterRehabilitation660930000TEXASYes

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
1676658MEDICARE OSCAR/CERTIFICATIONTEXAS

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: 3/30/2025

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