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General NPI Number Information
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NPI Number | 1073618310
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Entity Type | Individual
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Provider Name | CRYSTAL RUTLEDGE P.T.
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Gender | Female
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Dates
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Enumeration Date | 09/13/2006
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Last Update Date | 02/06/2014
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Provider Practice Location Address
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Address Line | 17045 EL CAMINO REAL STE 211
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City | HOUSTON
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State | TX
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Zip | 77058-2644
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Country | US
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Telephone | 832-284-4322
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Fax | 281-715-4232
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Provider Business Mailing Address
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Address Line | PO BOX 716
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City | LEAGUE CITY
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State | TX
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Zip | 77574-0716
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Country | US
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Telephone | 832-282-8457
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 11997865
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License Number State | TX
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