MEDICARE: COMPLETE PEDIATRIC THERAPY, PLLC

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	1159133	TX

General Provider Information

NPI Number	:	1336461953
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPLETE PEDIATRIC THERAPY, PLLC

Provider Business Mailing Address
First Line	:	1302 CHARDONNAY DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-3102
Country	:	US
Telephone Number	:	832-524-8784
Fax Number	:	346-570-4286

Provider Business Practice Location Address
First Line	:	1302 CHARDONNAY DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77077-3102
Country	:	US
Telephone Number	:	832-524-8784
Fax Number	:	346-570-4286

Authorized Official
Title or Position	:	OWNER
Name	:	SHEILA DALLEY
Credential	:	PT
Telephone Number	:	832-524-8784

Provider Enumeration Date	:	02/23/2010
Last Update Date	:	10/08/2025

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