MEDICARE: THERAPY WORKS INC

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	PT1038099	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0057GD	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1699761163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY WORKS INC

Provider Business Mailing Address
First Line	:	PO BOX 1254
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77501-1254
Country	:	US
Telephone Number	:	281-930-0900
Fax Number	:	281-930-0902

Provider Business Practice Location Address
First Line	:	321 W SAN AUGUSTINE ST
Second Line	:	STE. B
City	:	DEER PARK
State	:	TX
Zip	:	77536-4027
Country	:	US
Telephone Number	:	281-930-0900
Fax Number	:	281-930-0900

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ELISA MIRANDA
Credential	:	PT
Telephone Number	:	281-487-1760

Provider Enumeration Date	:	09/21/2005
Last Update Date	:	06/04/2009

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Directions to “THERAPY WORKS INC ” Practice Location

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