Healthcare Provider Details

I. General information

NPI: 1306144779
Provider Name (Legal Business Name): MVPT FOR KIDS, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/08/2011
Last Update Date: 03/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 CHELSEA BLVD
HOUSTON TX
77006-6202
US

IV. Provider business mailing address

2 CHELSEA BLVD
HOUSTON TX
77006-6202
US

V. Phone/Fax

Practice location:
  • Phone: 713-807-1131
  • Fax: 713-807-1141
Mailing address:
  • Phone: 713-807-1131
  • Fax: 713-807-1141

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number001077691
License Number StateTX

VIII. Authorized Official

Name: MISS MARIA S VARELA
Title or Position: OWNER
Credential: P.T.
Phone: 713-807-1131