Provider Demographics
NPI:1306281597
Name:BHF HEALTHCARE LLC
Entity type:Organization
Organization Name:BHF HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:WADE
Authorized Official - Last Name:PESNELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:979-480-9990
Mailing Address - Street 1:PO BOX 484
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-0484
Mailing Address - Country:US
Mailing Address - Phone:979-480-9990
Mailing Address - Fax:979-480-9985
Practice Address - Street 1:117 CIRCLE WAY ST
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5233
Practice Address - Country:US
Practice Address - Phone:979-480-9990
Practice Address - Fax:979-480-9985
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation