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General NPI Number Information
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NPI Number | 1902816457
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Entity Type | Organization
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Legal Business Name | HOUSTON AQUATIC THERAPY INSTITUTE, INC.
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 10/19/2012
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Provider Practice Location Address
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Address Line | 4710 KATY FREEWAY, SUITE A
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City | HOUSTON
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State | TX
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Zip | 77007-2204
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Country | US
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Telephone | 713-695-7800
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Fax | 713-695-7806
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Provider Business Mailing Address
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Address Line | 4710 KATY FREEWAY, SUITE A
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City | HOUSTON
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State | TX
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Zip | 77007-2204
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Country | US
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Telephone | 713-695-7800
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Fax | 713-695-7806
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. SHELLY LYNETTE LEE
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Credential |
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Telephone | 713-695-7800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 1081297
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License Number State | TX
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