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General NPI Number Information
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NPI Number | 1124130869
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Entity Type | Organization
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Legal Business Name | MEMORIAL PEDIATRIC THERAPY ASSOCIATES, PC
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/06/2025
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Provider Practice Location Address
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Address Line | 10375 RICHMOND AVE STE 1340
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City | HOUSTON
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State | TX
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Zip | 77042-4298
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Country | US
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Telephone | 713-787-6600
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Fax | 713-787-6601
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Provider Business Mailing Address
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Address Line | 10375 RICHMOND AVE STE 1340
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City | HOUSTON
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State | TX
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Zip | 77042-4298
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Country | US
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Telephone | 713-787-6600
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Fax | 713-787-6601
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | DAWN FORSMITH
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Credential | OTR
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Telephone | 713-787-6600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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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 | 261QH0700X
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Taxonomy Name | Hearing and Speech 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 | 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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