Provider Demographics
NPI:1801488663
Name:BAYOU SPORTS HEALTH PHYSICAL THERAPY
Entity type:Organization
Organization Name:BAYOU SPORTS HEALTH PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:OAKLEY
Authorized Official - Suffix:SR
Authorized Official - Credentials:LAT
Authorized Official - Phone:832-341-5896
Mailing Address - Street 1:4503 RANGER RUN
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2073
Mailing Address - Country:US
Mailing Address - Phone:832-341-5896
Mailing Address - Fax:
Practice Address - Street 1:7036 FM 1960 RD E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2704
Practice Address - Country:US
Practice Address - Phone:832-341-5896
Practice Address - Fax:281-605-6742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-03
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy