Healthcare Provider Details

I. General information

NPI: 1336628254
Provider Name (Legal Business Name): ARMAND DIZON PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 GREENHOUSE RD
HOUSTON TX
77084-6108
US

IV. Provider business mailing address

22415 LAVACA RANCH LN
KATY TX
77449-4887
US

V. Phone/Fax

Practice location:
  • Phone: 281-599-5540
  • Fax:
Mailing address:
  • Phone: 832-289-5806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1186098
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: