Provider Demographics
NPI:1376373340
Name:NEOMEDICA GROUP LLC
Entity type:Organization
Organization Name:NEOMEDICA GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:PENG
Authorized Official - Middle Name:
Authorized Official - Last Name:CHEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:512-574-0350
Mailing Address - Street 1:1538 MORITZ PARK
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-1137
Mailing Address - Country:US
Mailing Address - Phone:512-574-0350
Mailing Address - Fax:
Practice Address - Street 1:10015 BROADWAY ST STE E
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7879
Practice Address - Country:US
Practice Address - Phone:832-948-9922
Practice Address - Fax:832-948-9928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy