Healthcare Provider Details

I. General information

NPI: 1225884638
Provider Name (Legal Business Name): ARMANDO VAZQUEZ PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2024
Last Update Date: 04/26/2024
Certification Date: 04/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 GESSNER RD
HOUSTON TX
77080-3839
US

IV. Provider business mailing address

16403 LAKEWOOD FIELD DR
TOMBALL TX
77377-8789
US

V. Phone/Fax

Practice location:
  • Phone: 713-996-7996
  • Fax:
Mailing address:
  • Phone: 713-493-9047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2178854
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: