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Contact Information

1P410 SPORTS PERFORMANCE
7 PLAYER GROVE CT
THE WOODLANDS, TX77382-2124
 Phone: 832-791-5954
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Physician

111NS0005X 35 Chiropractic
Indicates primary specialty

NPI Profile & details for 1P410 SPORTS PERFORMANCE

NPI # 1588070528
LBN Legal business name 1P410 SPORTS PERFORMANCE
Authorized official DERRICK RAYMER - (DIRECTOR OF SPORTS PERFORMANCE)
Entity Organization
Organization subpart 1 No
Enumeration date 07/10/2014
Last updated 07/10/2014 - About 12 years ago
Identifiers
TX License # 12247
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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