Lake Jackson Rehabilitation and Wellness Center

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

650330002 Issued in TX

Legal business name

LAKE JACKSON REHABILITATION AND WELLNESS CENTER

Practice address

117 Circle Way St
Lake Jackson, TX 77566-5233

Phone

(979) 480-9400

Fax

(979) 480-9410

NPI assigned

Jun 19, 2006

Last updated

May 14, 2010By 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

Mr. Daniel Dominguez

Title

Chief Operating Officer

Phone

(281) 802-1441

Specialties & licenses 1

Addresses

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lauren Eileen Bowles, PT

  • Physical Therapist
  • Clute, TX
  • NPI 1871092999
  NPD (past)
• Karen Darby

  • Physical Therapist
  • Granbury, TX
  • NPI 1942310503
  NPD (past)
• Keith Wade Pesnell, P.T.

  • Physical Therapist
  • Angleton, TX
  • NPI 1194760371
  NPD (past)
• Gabriel Peterambrose Brooks, PT, MS

  • Physical Therapist
  • Mesa, AZ
  • NPI 1144206525
  NPD (past)

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

{
    "created_epoch": "1150675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273795200000",
    "number": "1952346264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 FLAMINGO ISLAND DR",
            "city": "MISSOURI CITY",
            "state": "TX",
            "postal_code": "774594611",
            "telephone_number": "281-802-1441",
            "fax_number": "713-634-2697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 CIRCLE WAY ST",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665233",
            "telephone_number": "979-480-9400",
            "fax_number": "979-480-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE JACKSON REHABILITATION AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-19",
        "last_updated": "2010-05-14",
        "status": "A",
        "authorized_official_last_name": "DOMINGUEZ",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "281-802-1441",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "650330002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lake Jackson Imaging Center
• Lake Jackson Operations, LLC (Elmcroft of Lake Jackson)
• Lake Jackson Oral and Maxillofacial Surgery, PLLC
• Lake Jackson Pediatric Speech PLLC
• Lake Jackson Plastic Surgery, PA
• Lake Jackson Urology PA
• Shirmeen Lakhani, D.P.M.
• Lamininvault, Corp. (Bridwell Wellness Center)
• Linda G Lane
• Karyn Langford

• Physical Therapist in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2010; 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.