MEDICARE: BETH FERGUSON 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
1	2251P0200X	Pediatric Physical Therapist	1115152	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326366865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETH FERGUSON PT

Provider Business Mailing Address
First Line	:	7066 LAKEVIEW HAVEN DR
Second Line	:	SUITE 133
City	:	HOUSTON
State	:	TX
Zip	:	77095-2568
Country	:	US
Telephone Number	:	281-763-2196
Fax Number	:	281-763-2196

Provider Business Practice Location Address
First Line	:	7066 LAKEVIEW HAVEN DR
Second Line	:	SUITE 133
City	:	HOUSTON
State	:	TX
Zip	:	77095-2568
Country	:	US
Telephone Number	:	281-763-2196
Fax Number	:	281-763-2196

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

Provider Enumeration Date	:	05/07/2010
Last Update Date	:	10/14/2015

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Directions to “ BETH FERGUSON PT” Practice Location

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