Provider Demographics
NPI:1225850803
Name:TRISTAR INJURY CLINIC
Entity type:Organization
Organization Name:TRISTAR INJURY CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NAM
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-425-3780
Mailing Address - Street 1:12445 EAST FWY # 100A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-5522
Mailing Address - Country:US
Mailing Address - Phone:713-425-3780
Mailing Address - Fax:713-426-4610
Practice Address - Street 1:12445 EAST FWY # 100A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-5522
Practice Address - Country:US
Practice Address - Phone:713-425-3780
Practice Address - Fax:713-426-4610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty