MEDICARE: HOUSTON THERAPY CONSULT

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	224Z00000X	Occupational Therapy Assistant	211154	TX

General Provider Information

NPI Number	:	1649557802
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON THERAPY CONSULT

Provider Business Mailing Address
First Line	:	3300 S GESSNER RD
Second Line	:	SUITE 115
City	:	HOUSTON
State	:	TX
Zip	:	77063-5100
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3300 S GESSNER RD
Second Line	:	SUITE 115
City	:	HOUSTON
State	:	TX
Zip	:	77063-5100
Country	:	US
Telephone Number	:	832-830-3012
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	VICTOR DIMKPA
Credential	:
Telephone Number	:	832-830-3012

Provider Enumeration Date	:	11/15/2011
Last Update Date	:	11/15/2011

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Directions to “HOUSTON THERAPY CONSULT ” Practice Location

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