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NPI Code Detail

MEDICARE: DR. ANTOINETTE JAMIL' HUMPHREY AVERY DPT

MEDICARE:  DR. ANTOINETTE JAMIL' HUMPHREY AVERY  DPT
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 Therapist1168930TX

General Provider Information

NPI Number : 1417141698
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTOINETTE JAMIL' HUMPHREY AVERY DPT
Provider Business Mailing Address
First Line : 6360 W SAM HOUSTON PKWY N
Second Line : NORTH, SUITE 200
City : HOUSTON
State : TX
Zip : 77041-5164
Country : US
Telephone Number : 713-280-0363
Fax Number : 713-208-3457
Provider Business Practice Location Address
First Line : 6360 W SAM HOUSTON PKWY N
Second Line : NORTH, SUITE 200
City : HOUSTON
State : TX
Zip : 77041-5164
Country : US
Telephone Number : 713-280-0363
Fax Number : 713-208-3457
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2007
Last Update Date : 08/30/2007

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Directions to “ DR. ANTOINETTE JAMIL' HUMPHREY AVERY DPT” Practice Location

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