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General NPI Number Information
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NPI Number | 1891168035
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Entity Type | Organization
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Legal Business Name | QUEST PEDIATRIC THERAPY, INC.
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Dates
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Enumeration Date | 11/10/2015
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Last Update Date | 11/10/2015
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Provider Practice Location Address
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Address Line | 22702 NEWCOURT PLACE ST
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City | TOMBALL
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State | TX
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Zip | 77375-1125
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Country | US
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Telephone | 281-546-1228
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Fax |
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Provider Business Mailing Address
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Address Line | 22702 NEWCOURT PLACE ST
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City | TOMBALL
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State | TX
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Zip | 77375-1125
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | SUSAN VON VILLAS
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Credential | P.T., M.S., D.P.T.
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Telephone | 281-546-1228
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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 | 1171680
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License Number State | TX
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