MEDICARE: MR. JOHN SHELTON PYLES SR. M.S.P.T.

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	1111532	TX

General Provider Information

NPI Number	:	1518962455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN SHELTON PYLES SR. M.S.P.T.

Provider Business Mailing Address
First Line	:	210 BLUE CASTLE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-1512
Country	:	US
Telephone Number	:	832-236-9694
Fax Number	:	713-330-4203

Provider Business Practice Location Address
First Line	:	210 BLUE CASTLE LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77015-1512
Country	:	US
Telephone Number	:	832-236-9694
Fax Number	:	713-330-4203

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

Provider Enumeration Date	:	06/16/2005
Last Update Date	:	10/02/2007

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Directions to “ MR. JOHN SHELTON PYLES SR. M.S.P.T.” Practice Location

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