MEDICARE: OPEN DOOR PEDIATRIC THERAPY, LLC

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225200000X	Physical Therapy Assistant
2	225X00000X	Occupational Therapist
3	225XE0001X	Environmental Modification Occupational Therapist
4	225XF0002X	Feeding, Eating & Swallowing Occupational Therapist
5	225XM0800X	Mental Health Occupational Therapist
6	225XP0019X	Physical Rehabilitation Occupational Therapist
7	225XP0200X	Pediatric Occupational Therapist
8	235Z00000X	Speech-Language Pathologist
9	224Z00000X	Occupational Therapy Assistant
10	224ZE0001X	Environmental Modification Occupational Therapy Assistant
11	224ZF0002X	Feeding, Eating & Swallowing Occupational Therapy Assistant
12	225100000X	Physical Therapist
13	2251P0200X	Pediatric Physical Therapist
14	2251X0800X	Orthopedic Physical Therapist
15	2355S0801X	Speech-Language Assistant

NPI Number	:	1467849505
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OPEN DOOR PEDIATRIC THERAPY, LLC

Provider Business Mailing Address
First Line	:	7915 FM 1960 RD W STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-2285
Country	:	US
Telephone Number	:	713-352-8090
Fax Number	:	281-754-4253

Provider Business Practice Location Address
First Line	:	7915 FM 1960 RD W STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-2285
Country	:	US
Telephone Number	:	713-352-8090
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	AMBER HUMPHREY
Credential	:	OTR, MOT
Telephone Number	:	713-301-0958

Provider Enumeration Date	:	04/15/2015
Last Update Date	:	07/11/2024