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General NPI Number Information
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NPI Number | 1336960301
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Entity Type | Organization
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Legal Business Name | EMERELLI, PLLC
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Dates
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Enumeration Date | 10/22/2024
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Last Update Date | 10/29/2024
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Provider Practice Location Address
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Address Line | 2714 OSLER BLVD
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City | BRYAN
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State | TX
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Zip | 77802-2517
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Country | US
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Telephone | 979-776-2225
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Fax | 979-776-7945
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Provider Business Mailing Address
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Address Line | PO BOX 55
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City | WELLBORN
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State | TX
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Zip | 77881-0055
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. KATIE DAVENPORT
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Credential | PT, DPT, COMT
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Telephone | 979-776-2225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251E1300X
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Taxonomy Name | Clinical Electrophysiology Physical 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 | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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Taxonomy #4
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number |
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Taxonomy #5
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Taxonomy Code | 2251H1300X
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Taxonomy Name | Human Factors Physical Therapist
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License Number |
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License Number State |
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Taxonomy #6
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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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