Healthcare Provider Details

I. General information

NPI: 1609745017
Provider Name (Legal Business Name): PIPER SHEA UMBRA PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6767 LAKE WOODLANDS DR STE F
THE WOODLANDS TX
77382-2566
US

IV. Provider business mailing address

6767 LAKE WOODLANDS DR STE F
THE WOODLANDS TX
77382-2566
US

V. Phone/Fax

Practice location:
  • Phone: 281-364-1122
  • Fax:
Mailing address:
  • Phone: 281-364-1122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2168819
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: