Provider Demographics
NPI:1548995061
Name:HOUSTON HYPERBARIC OXYGEN CENTER LLC
Entity type:Organization
Organization Name:HOUSTON HYPERBARIC OXYGEN CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:COPUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-713-6543
Mailing Address - Street 1:18525 W LAKE HOUSTON PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3446
Mailing Address - Country:US
Mailing Address - Phone:281-713-6543
Mailing Address - Fax:
Practice Address - Street 1:18525 W LAKE HOUSTON PKWY STE 104
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-3446
Practice Address - Country:US
Practice Address - Phone:281-713-6543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center