Organization
P, M, & R SPECIALISTS OF TEXAS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL BODIN (MEDICAL LIASON)
(832) 777-7581
Entity
Organization
Contact information
Practice address
14405 WALTERS, STE A, HOUSTON, TX 77014
(832) 777-7581
(832) 532-9775
Mailing address
3303 CANDLEOAK DR, SPRING, TX 77388-5210
(832) 777-7581
(832) 532-9775
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
111NX0100X
Occupational Health Chiropractor
Primary
—
—
174H00000X
Health Educator
—
—
225XP0019X
Physical Rehabilitation Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32061969310
WORKERS COMP
TX
Enumeration date
11/15/2016
Last updated
11/16/2016
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