Organization
PHYSICAL MEDICINE & REHAB
Active
Organization
PHYSICAL MEDICINE & REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER LANGELAND (OWNER)
(281) 354-4000
Entity
Organization
Contact information
Practice address
25404 HIGHWAY 59, SUITE 102, PORTER, TX 77365-5295
(281) 354-4000
(281) 354-8128
Mailing address
25404 HIGHWAY 59, SUITE 102, PORTER, TX 77365-5295
(281) 354-4000
(281) 354-8128
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
4256
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0049DJ
BCBS GROUP
TX
Enumeration date
12/31/2014
Last updated
06/13/2016
Update your record
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