MEDICARE: MR. CHAD A ELMS 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
1	225100000X	Physical Therapist	1134427	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00285986	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	86570T	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1972511269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CHAD A ELMS PT

Provider Business Mailing Address
First Line	:	2020 NORTH LOOP W STE 135
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8142
Country	:	US
Telephone Number	:	210-372-9600
Fax Number	:	210-372-9923

Provider Business Practice Location Address
First Line	:	2020 NORTH LOOP W STE 135
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8142
Country	:	US
Telephone Number	:	210-372-9600
Fax Number	:	210-372-9923

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

Provider Enumeration Date	:	08/03/2006
Last Update Date	:	12/04/2023

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Directions to “ MR. CHAD A ELMS PT” Practice Location

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