MEDICARE: ELENA GACITUA LPT

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	1081156	TX

General Provider Information

NPI Number	:	1619152956
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELENA GACITUA LPT

Provider Business Mailing Address
First Line	:	4625 NORTH FWY STE 325
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77022-2928
Country	:	US
Telephone Number	:	713-490-1077
Fax Number	:	713-692-2559

Provider Business Practice Location Address
First Line	:	4625 NORTH FWY STE 325
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77022-2928
Country	:	US
Telephone Number	:	713-490-1077
Fax Number	:	713-692-2559

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

Provider Enumeration Date	:	01/06/2008
Last Update Date	:	01/06/2008

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Directions to “ ELENA GACITUA LPT” Practice Location

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