Provider Demographics
NPI:1194216853
Name:MAIN STREET PHYSICAL THERAPY SOLUTIONS INC
Entity type:Organization
Organization Name:MAIN STREET PHYSICAL THERAPY SOLUTIONS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANASO
Authorized Official - Middle Name:U
Authorized Official - Last Name:IGBANI
Authorized Official - Suffix:
Authorized Official - Credentials:BA
Authorized Official - Phone:713-382-0380
Mailing Address - Street 1:10006 BISSONNET ST SUITE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036
Mailing Address - Country:US
Mailing Address - Phone:713-382-0380
Mailing Address - Fax:713-271-1600
Practice Address - Street 1:10006 BISSONNET ST SUITE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036
Practice Address - Country:US
Practice Address - Phone:713-382-0380
Practice Address - Fax:713-271-1600
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MAIN STREET PHYSICAL THERAPY SOLUTIONS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-29
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health