MEDICARE: MELANIE BENNETT 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	225100000X	Physical Therapist	1212303	TX

General Provider Information

NPI Number	:	1154698082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELANIE BENNETT DPT

Provider Business Mailing Address
First Line	:	5771 ENID ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77009-1208
Country	:	US
Telephone Number	:	713-880-4400
Fax Number	:

Provider Business Practice Location Address
First Line	:	9940 W SAM HOUSTON PKWY S
Second Line	:	STE 320
City	:	HOUSTON
State	:	TX
Zip	:	77099-5104
Country	:	US
Telephone Number	:	832-300-2626
Fax Number	:

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

Provider Enumeration Date	:	11/21/2011
Last Update Date	:	11/21/2011

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Directions to “ MELANIE BENNETT DPT” Practice Location

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