MEDICARE: KIMBERLY SAM AING 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	2251X0800X	Orthopedic Physical Therapist	1270959	TX

General Provider Information

NPI Number	:	1083069785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KIMBERLY SAM AING PT, DPT

Provider Business Mailing Address
First Line	:	2547 WILLOW DR
Second Line	:
City	:	STAFFORD
State	:	TX
Zip	:	77477-5630
Country	:	US
Telephone Number	:	713-277-8738
Fax Number	:

Provider Business Practice Location Address
First Line	:	1102 PINEMONT DR STE C
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-1323
Country	:	US
Telephone Number	:	713-277-8738
Fax Number	:

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

Provider Enumeration Date	:	05/01/2016
Last Update Date	:	08/10/2021

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