Provider Demographics
NPI:1306509377
Name:CENTER FOR SPINE, SPORTS AND REHABILITATION EXCELLENCE PA
Entity type:Organization
Organization Name:CENTER FOR SPINE, SPORTS AND REHABILITATION EXCELLENCE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BENOY
Authorized Official - Middle Name:VARKEY
Authorized Official - Last Name:BENNY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-590-2700
Mailing Address - Street 1:1111 HIGHWAY 6 STE 145
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4960
Mailing Address - Country:US
Mailing Address - Phone:713-804-9275
Mailing Address - Fax:
Practice Address - Street 1:1111 HIGHWAY 6 STE 145
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4960
Practice Address - Country:US
Practice Address - Phone:713-804-9275
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-18
Last Update Date:2021-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty