MEDICARE: SIMONE JOELLE MIXON 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

General Provider Information

NPI Number	:	1922930759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMONE JOELLE MIXON DPT

Provider Business Mailing Address
First Line	:	11666 GULF POINTE DR APT 6308
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-2615
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11666 GULF POINTE DR APT 6308
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77089-2615
Country	:	US
Telephone Number	:	225-247-3908
Fax Number	:

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

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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Directions to “ SIMONE JOELLE MIXON DPT” Practice Location

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