MEDICARE: HOUSTON ON DEMAND PHYSICAL THERAPY LLC

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

General Provider Information

NPI Number	:	1801493523
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOUSTON ON DEMAND PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	1300 W SAM HOUSTON PKWY S STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-2453
Country	:	US
Telephone Number	:	713-297-7052
Fax Number	:	713-430-4009

Provider Business Practice Location Address
First Line	:	1300 W SAM HOUSTON PKWY S STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77042-2453
Country	:	US
Telephone Number	:	713-297-7052
Fax Number	:	713-430-4009

Authorized Official
Title or Position	:	VP/AUTHORIZED OFFICIAL
Name	:	RICHARD BINSTEIN
Credential	:
Telephone Number	:	713-297-7000

Provider Enumeration Date	:	10/06/2020
Last Update Date	:	10/06/2020

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