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Organization
EAGLE'S TRACE INC
Active
Organization
EAGLE'S TRACE INC
Active
Other names
Outpatient Rehabilitation Agency at Eagle's Trace
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES K WALTER (FINANCE DIRECTOR)
(410) 402-2315
Entity
Organization
Contact information
Practice address
14703 EAGLE VISTA DRIVE, ATTN: REHABILITATION MGR, HOUSTON, TX 77077-5394
(281) 249-7000
(410) 204-7237
Mailing address
14703 EAGLE VISTA DRIVE, ATTN: EXECUTIVE DIRECTOR, HOUSTON, TX 77077-5394
(281) 249-7000
(410) 204-7237
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
660930000
TX
Other
Enumeration date
11/02/2006
Last updated
06/20/2014
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