Healthcare Provider Details

I. General information

NPI: 1932576246
Provider Name (Legal Business Name): JUSTIN TZOU
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2015
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 E SAM HOUSTON PKWY S
PASADENA TX
77505-3959
US

IV. Provider business mailing address

13406 ORCHARD SHADOWS DR
RICHMOND TX
77407-3230
US

V. Phone/Fax

Practice location:
  • Phone: 281-487-2786
  • Fax:
Mailing address:
  • Phone: 408-318-1649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1263318
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: