MEDICARE: ASHLEY AMANDA SPIEGEL PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1296251	TX

General Provider Information

NPI Number	:	1013432079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY AMANDA SPIEGEL PT

Provider Business Mailing Address
First Line	:	1300 N POST OAK RD APT 1306
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-5434
Country	:	US
Telephone Number	:	806-241-4646
Fax Number	:

Provider Business Practice Location Address
First Line	:	4854 BEECHNUT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-1604
Country	:	US
Telephone Number	:	713-660-0663
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2017
Last Update Date	:	08/10/2017

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