MEDICARE: ARLEEN J VISTRO P.T.

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	1066371	TX

General Provider Information

NPI Number	:	1235410531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARLEEN J VISTRO P.T.

Provider Business Mailing Address
First Line	:	1829 AUGUSTA DR
Second Line	:	2
City	:	HOUSTON
State	:	TX
Zip	:	77057-3143
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1829 AUGUSTA DR
Second Line	:	2
City	:	HOUSTON
State	:	TX
Zip	:	77057-3143
Country	:	US
Telephone Number	:	832-752-4987
Fax Number	:

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

Provider Enumeration Date	:	08/31/2011
Last Update Date	:	08/31/2011

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