Provider Demographics
NPI:1215234927
Name:THERAMAX THERAPY SERVICES, PC
Entity type:Organization
Organization Name:THERAMAX THERAPY SERVICES, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MISS
Authorized Official - First Name:RISTY
Authorized Official - Middle Name:DELUMPA
Authorized Official - Last Name:DURBIN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:713-244-9505
Mailing Address - Street 1:7211 REGENCY SQUARE BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-3138
Mailing Address - Country:US
Mailing Address - Phone:713-344-1214
Mailing Address - Fax:888-336-7050
Practice Address - Street 1:7211 REGENCY SQUARE BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-3138
Practice Address - Country:US
Practice Address - Phone:713-344-1214
Practice Address - Fax:888-336-7050
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THERAMAX THERAPY SERVICES, PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-15
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1155398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty