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General NPI Number Information
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NPI Number | 1457972515
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Entity Type | Individual
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Provider Name | VIRALBHAI MUKESHBHAI BHAKTA PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 04/29/2020
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Last Update Date | 04/29/2020
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Provider Practice Location Address
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Address Line | 16000 PARK TEN PL STE 204
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City | HOUSTON
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State | TX
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Zip | 77084-7296
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Country | US
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Telephone | 832-321-4728
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Fax |
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Provider Business Mailing Address
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Address Line | 4222 SPENCER HWY
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City | PASADENA
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State | TX
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Zip | 77504-1211
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Country | US
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Telephone | 626-848-2869
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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 | 1304217
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License Number State | TX
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