MEDICARE: BAILEY LUKE PT, DPT

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	2251P0200X	Pediatric Physical Therapist	1407325	TX

General Provider Information

NPI Number	:	1023970308
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BAILEY LUKE PT, DPT

Provider Business Mailing Address
First Line	:	2602 WOODSORREL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77084-4348
Country	:	US
Telephone Number	:	936-391-1173
Fax Number	:

Provider Business Practice Location Address
First Line	:	19298 W LAKE HOUSTON PKWY
Second Line	:
City	:	HUMBLE
State	:	TX
Zip	:	77346-4827
Country	:	US
Telephone Number	:	832-828-4900
Fax Number	:

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

Provider Enumeration Date	:	11/25/2025
Last Update Date	:	11/25/2025

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