MEDICARE: RICHARD B CHAE PT, DPT, CSCS

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	6703	NV
2	225100000X	Physical Therapist	1372467	TX

General Provider Information

NPI Number	:	1528774015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICHARD B CHAE PT, DPT, CSCS

Provider Business Mailing Address
First Line	:	17219 LAGUNA TRAIL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-7048
Country	:	US
Telephone Number	:	281-660-2131
Fax Number	:

Provider Business Practice Location Address
First Line	:	11709 BOUDREAUX RD
Second Line	:
City	:	TOMBALL
State	:	TX
Zip	:	77375-7655
Country	:	US
Telephone Number	:	281-886-0718
Fax Number	:	281-823-9603

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

Provider Enumeration Date	:	01/27/2023
Last Update Date	:	07/08/2025

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