Angie Physical Medicine and Rehabilitation Center

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

ANGIE PHYSICAL MEDICINE AND REHABILITATION CENTER

Practice address

22653 Highway 21
Angie, LA 70426

Phone

(713) 894-3576

Fax

(713) 928-3488

NPI assigned

Dec 21, 2007

Last updated

Dec 21, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Otis Lee Wells

Title

General Manager

Phone

(713) 894-3576

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198195200000",
    "number": "1003090366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22653 HIGHWAY 21",
            "city": "ANGIE",
            "state": "LA",
            "postal_code": "70426",
            "telephone_number": "713-894-3576",
            "fax_number": "713-928-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22653 HIGHWAY 21",
            "city": "ANGIE",
            "state": "LA",
            "postal_code": "70426",
            "telephone_number": "713-894-3576",
            "fax_number": "713-928-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGIE PHYSICAL MEDICINE AND REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-21",
        "last_updated": "2007-12-21",
        "status": "A",
        "authorized_official_last_name": "WELLS",
        "authorized_official_first_name": "OTIS",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "GENERAL MANAGER",
        "authorized_official_telephone_number": "713-894-3576"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angie Medical Clinic, LLC
• Angie Medical Clinic,LLC
• Pamela Michelle Baker, LMSW
• Lillie Jessina Calloway-Reed, RN CNS
• Kaye B Crain, LPC, MFTC, NCC
• Daughters of Zion Refuge and Shelter
• Divine Touch Care LLC

• Specialist in Angie, LA
• Providers in Angie, LA by specialty
• Specialist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.