MEDICARE: RELIANT PEDIATRIC THERAPY SERVICES, PC

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
2	225X00000X	Occupational Therapist
3	235Z00000X	Speech-Language Pathologist
4	251S00000X	Community/Behavioral Health Agency
5	261QR0400X	Rehabilitation Clinic/Center
6	251E00000X	Home Health Agency	014075	TX

General Provider Information

NPI Number	:	1457659096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RELIANT PEDIATRIC THERAPY SERVICES, PC

Provider Business Mailing Address
First Line	:	21630 MERCHANTS WAY
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-2514
Country	:	US
Telephone Number	:	832-230-1518
Fax Number	:	281-741-7355

Provider Business Practice Location Address
First Line	:	21630 MERCHANTS WAY
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77449-2514
Country	:	US
Telephone Number	:	832-230-1518
Fax Number	:	281-741-7355

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. OLENDU EKPE OKORAFOR
Credential	:	OTR
Telephone Number	:	713-366-2080

Provider Enumeration Date	:	03/07/2011
Last Update Date	:	03/20/2018

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