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General NPI Number Information
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NPI Number | 1861375230
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Entity Type | Individual
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Provider Name | VIVIANA R CORREA PTA
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Gender | Female
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Dates
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Enumeration Date | 07/31/2025
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Last Update Date | 07/31/2025
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Provider Practice Location Address
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Address Line | 4606 FM 1960 RD W STE 520
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City | HOUSTON
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State | TX
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Zip | 77069-4629
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Country | US
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Telephone | 346-333-2794
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Fax | 832-404-2649
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Provider Business Mailing Address
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Address Line | 7615 STONEBRIDGE CREEK LN
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City | HUMBLE
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State | TX
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Zip | 77396-4289
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Country | US
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Telephone | 832-527-1890
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2187870
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License Number State | TX
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