Healthcare Provider Details

I. General information

NPI: 1043988694
Provider Name (Legal Business Name): TIMOTHY EDWARD COLE MT-BC, NMT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 08/31/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16339 STUEBNER AIRLINE RD APT 1108
SPRING TX
77379-7358
US

IV. Provider business mailing address

16339 STUEBNER AIRLINE RD APT 1108
SPRING TX
77379-7358
US

V. Phone/Fax

Practice location:
  • Phone: 713-416-8716
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225A00000X
TaxonomyMusic Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: