MEDICARE: ALYSSA ECKSTEIN PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1360834	TX

General Provider Information

NPI Number	:	1265168280
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALYSSA ECKSTEIN PT, DPT

Provider Business Mailing Address
First Line	:	6108 S RICE AVE STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-2983
Country	:	US
Telephone Number	:	713-660-0663
Fax Number	:

Provider Business Practice Location Address
First Line	:	6108 S RICE AVE STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-2983
Country	:	US
Telephone Number	:	713-660-0663
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2022
Last Update Date	:	08/01/2022

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