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General NPI Number Information
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NPI Number | 1174859631
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Entity Type | Organization
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Legal Business Name | US PT TEXAS INC
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Dates
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Enumeration Date | 10/19/2009
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Last Update Date | 10/19/2009
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Provider Practice Location Address
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Address Line | 7065 AIRWAYS BLVD SUITE 110
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City | SOUTHAVEN
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State | MS
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Zip | 38671-5873
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Country | US
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Telephone | 662-349-8997
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Fax | 662-349-8987
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Provider Business Mailing Address
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Address Line | 7065 AIRWAYS BLVD SUITE 110
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City | SOUTHAVEN
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State | MS
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Zip | 38671-5873
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Country | US
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Telephone | 662-349-8997
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Fax | 662-349-8987
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Authorized Official
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Title or Position | VP, AUTHORIZED OFFICIAL
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Name | CHRISTOPHER D CORRIGAN
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Credential | JD
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Telephone | 713-297-7000
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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 |
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License Number State |
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