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General NPI Number Information
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NPI Number | 1891174272
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Entity Type | Organization
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Legal Business Name | ALPHA ON-SITE PHYSICAL THERAPY
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Dates
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Enumeration Date | 05/19/2015
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 600 N DAIRY ASHFORD RD
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City | HOUSTON
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State | TX
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Zip | 77079-1100
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Country | US
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Telephone | 832-547-3508
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Fax | 713-275-7818
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Provider Business Mailing Address
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Address Line | 1387 STUDER ST
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City | HOUSTON
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State | TX
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Zip | 77007-3236
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Country | US
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Telephone | 832-547-3508
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Fax | 713-275-7818
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Authorized Official
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Title or Position | OWNER/CLINIC DIRECTOR
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Name | DR. RYAN LEE ARDOIN
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Credential | PT
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Telephone | 832-547-3508
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1208632
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License Number State | TX
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