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General NPI Number Information
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NPI Number | 1811250012
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Entity Type | Organization
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Legal Business Name | PROGRESSIVE PHYSICAL THERAPY
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Dates
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Enumeration Date | 06/21/2012
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Last Update Date | 06/21/2012
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Provider Practice Location Address
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Address Line | 15211 PARK ROW 223
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City | HOUSTON
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State | TX
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Zip | 77084-4137
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Country | US
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Telephone | 832-419-3155
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Fax | 888-826-7916
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Provider Business Mailing Address
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Address Line | 15211 PARK ROW 223
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City | HOUSTON
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State | TX
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Zip | 77084-4137
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Country | US
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Telephone | 832-419-3155
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Fax | 888-826-7916
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Authorized Official
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Title or Position | OWNER
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Name | MISS LAURA MILENA GUARIN
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Credential | PT
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Telephone | 832-419-3155
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | 106982
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License Number State | TX
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