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General NPI Number Information
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NPI Number | 1689123598
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Entity Type | Organization
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Legal Business Name | TWINKLE TYKES THERAPY
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Dates
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Enumeration Date | 10/04/2016
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 7703 MISTY FERN CT
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City | HOUSTON
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State | TX
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Zip | 77095-4450
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Country | US
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Telephone | 281-682-0554
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Fax | 346-978-5755
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Provider Business Mailing Address
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Address Line | 7703 MISTY FERN CT
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City | HOUSTON
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State | TX
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Zip | 77095-4450
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Country | US
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Telephone | 281-682-0554
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Fax | 346-978-5755
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Authorized Official
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Title or Position | OWNER - PHYSICAL THERAPIST
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Name | BETH FERGUSON
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Credential | PT
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Telephone | 281-682-0554
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 1115152
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License Number State | TX
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