Healthcare Provider Details
I. General information
NPI: 1710656087
Provider Name (Legal Business Name): EVOLVE HAND THERAPY AND WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/09/2021
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
8 GREENWAY PLZ STE 1525
HOUSTON TX
77046-0812
US
IV. Provider business mailing address
3139 W HOLCOMBE BLVD # A170
HOUSTON TX
77025-1533
US
V. Phone/Fax
- Phone: 713-401-6014
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XE1200X |
| Taxonomy | Ergonomics Occupational Therapist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225XP0019X |
| Taxonomy | Physical Rehabilitation Occupational Therapist |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225XH1200X |
| Taxonomy | Hand Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
EMILY
HINES
Title or Position: OWNER/ LEAD OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 713-401-6014