MEDICARE: INFINITE ATHLETE PHYSICAL THERAPY

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	:	1801515127
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INFINITE ATHLETE PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	4922 RIDGEWAY DR
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77504-1710
Country	:	US
Telephone Number	:	870-265-0159
Fax Number	:

Provider Business Practice Location Address
First Line	:	1318 UNDERWOOD RD
Second Line	:
City	:	LA PORTE
State	:	TX
Zip	:	77571-9471
Country	:	US
Telephone Number	:	737-471-2118
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF PHYSICAL THERAPY
Name	:	DR. ARTHUR J LEE III
Credential	:	PT, DPT
Telephone Number	:	870-265-0159

Provider Enumeration Date	:	08/22/2022
Last Update Date	:	08/22/2022

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Directions to “INFINITE ATHLETE PHYSICAL THERAPY ” Practice Location

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