MEDICARE: CHRISTINE ROSS 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	225100000X	Physical Therapist	1197176	TX

General Provider Information

NPI Number	:	1225814189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE ROSS PT, DPT

Provider Business Mailing Address
First Line	:	6202 IRONWOOD CT
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-7404
Country	:	US
Telephone Number	:	281-796-5247
Fax Number	:

Provider Business Practice Location Address
First Line	:	8405 WYNBROOK ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77061-2452
Country	:	US
Telephone Number	:	281-501-0056
Fax Number	:

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

Provider Enumeration Date	:	09/06/2023
Last Update Date	:	10/11/2023

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