Organization
TEJAS SPINE AND REHAB LLC
Active
Organization
TEJAS SPINE AND REHAB LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN MICHAEL RAIMONDO DC (ADMINISTRATOR)
(832) 767-2538
Entity
Organization
Contact information
Practice address
3222 BURKE RD, SUITE 104, PASADENA, TX 77504-1859
(832) 767-2538
(832) 767-2562
Mailing address
3222 BURKE RD, SUITE 104, PASADENA, TX 77504-1859
(832) 767-2538
(832) 767-2562
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
8322
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8322
LICENSE
TX
Enumeration date
04/05/2011
Last updated
04/05/2011
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