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NPI Code Detail

MEDICARE: MRS. ELLEN VILLANUEVA OFIELD PT

MEDICARE: MRS. ELLEN VILLANUEVA OFIELD PT
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
1225100000XPhysical Therapist1071470TX

General Provider Information

NPI Number : 1255814877
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELLEN VILLANUEVA OFIELD PT
Provider Business Mailing Address
First Line : 1341 BLALOCK RD
Second Line :
City : HOUSTON
State : TX
Zip : 77055-6427
Country : US
Telephone Number : 832-657-8363
Fax Number : 713-496-1811
Provider Business Practice Location Address
First Line : 1341 BLALOCK RD
Second Line :
City : HOUSTON
State : TX
Zip : 77055-6427
Country : US
Telephone Number : 832-657-8363
Fax Number : 713-496-1811
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/10/2018
Last Update Date : 09/10/2018

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