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General NPI Number Information
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NPI Number | 1750466736
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Entity Type | Individual
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Provider Name | CHERYL JOAN DETTEN P.T.
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 12/06/2024
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Provider Practice Location Address
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Address Line | 1431 GREENWAY DR STE 500
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City | IRVING
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State | TX
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Zip | 75038-2444
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Country | US
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Telephone | 713-783-8181
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Fax | 832-781-2001
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Provider Business Mailing Address
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Address Line | 12871 WESTHORPE DR
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City | HOUSTON
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State | TX
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Zip | 77077-3736
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Country | US
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Telephone | 713-504-3442
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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 | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 1143097
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1143097
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License Number State | TX
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