Provider Demographics
NPI:1528676434
Name:IMAGINE ABUNDANCE LLC
Entity type:Organization
Organization Name:IMAGINE ABUNDANCE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PABLO
Authorized Official - Middle Name:CESAR
Authorized Official - Last Name:MEILICKE
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:512-426-6642
Mailing Address - Street 1:71 E GREEN GABLES CIR
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1145
Mailing Address - Country:US
Mailing Address - Phone:512-426-6642
Mailing Address - Fax:
Practice Address - Street 1:2990 RICHMOND AVE STE 432
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3115
Practice Address - Country:US
Practice Address - Phone:512-426-6642
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-16
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty