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NPI Code Detail

MEDICARE: OMMAR ORTUVIA PT

MEDICARE:   OMMAR  ORTUVIA  PT
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
1225100000XPhysical Therapist1186243TX

General Provider Information

NPI Number : 1336617299
Entity Type Code : Individual
Provider Name (Legal Business Name) : OMMAR ORTUVIA PT
Provider Business Mailing Address
First Line : 16427 JADESTONE TERRACE LN
Second Line :
City : HOUSTON
State : TX
Zip : 77044-1167
Country : US
Telephone Number : 832-328-8972
Fax Number :
Provider Business Practice Location Address
First Line : 19298 W LAKE HOUSTON PKWY STE 240
Second Line :
City : HUMBLE
State : TX
Zip : 77346-4827
Country : US
Telephone Number : 832-828-4990
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2018
Last Update Date : 11/08/2018

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Directions to “ OMMAR ORTUVIA PT” Practice Location

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