Provider Demographics
NPI:1548518673
Name:RECOVERY & GOALS LLC
Entity type:Organization
Organization Name:RECOVERY & GOALS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VARSHA
Authorized Official - Middle Name:REDDY
Authorized Official - Last Name:GILLALA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:248-633-4514
Mailing Address - Street 1:11666 GULF POINTE DR
Mailing Address - Street 2:APT 8204
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-2635
Mailing Address - Country:US
Mailing Address - Phone:248-633-4514
Mailing Address - Fax:
Practice Address - Street 1:1737 NORTH LOOP W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1425
Practice Address - Country:US
Practice Address - Phone:713-869-5551
Practice Address - Fax:713-869-3230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-21
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP1867208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty