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NPI Code Detail

MEDICARE: MR. DAWN MARIE COMEAUX PT

MEDICARE: MR. DAWN MARIE COMEAUX 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
12251P0200XPediatric Physical Therapist1138089TX

General Provider Information

NPI Number : 1275690711
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DAWN MARIE COMEAUX PT
Provider Business Mailing Address
First Line : 3107 EDGEWOOD DR
Second Line :
City : PEARLAND
State : TX
Zip : 77584-9546
Country : US
Telephone Number : 281-692-9623
Fax Number :
Provider Business Practice Location Address
First Line : 8021 BISSONNET ST
Second Line :
City : HOUSTON
State : TX
Zip : 77074-5200
Country : US
Telephone Number : 713-774-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2007
Last Update Date : 07/08/2007

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