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General NPI Number Information
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NPI Number | 1073196382
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Entity Type | Organization
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Legal Business Name | SPE MEDICAL & PHYSICAL THERAPY CLINIC PLLC
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Dates
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Enumeration Date | 05/04/2021
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Last Update Date | 05/04/2021
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Provider Practice Location Address
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Address Line | 10103 FONDREN RD STE 150A
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City | HOUSTON
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State | TX
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Zip | 77096-4556
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Country | US
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Telephone | 128-166-0866
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Fax |
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Provider Business Mailing Address
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Address Line | 10103 FONDREN RD STE 150A
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City | HOUSTON
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State | TX
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Zip | 77096-4556
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Country | US
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Telephone | 128-166-0866
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | STELLA C ENELICHI
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Credential | PT. DPT
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Telephone | 281-660-8661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081N0008X
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Taxonomy Name | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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