MEDICARE: JEREMY C WINDHAM PT

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	1232711	TX

General Provider Information

NPI Number	:	1891129607
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEREMY C WINDHAM PT

Provider Business Mailing Address
First Line	:	2020 NORTH LOOP W STE 135
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8142
Country	:	US
Telephone Number	:	281-524-6488
Fax Number	:

Provider Business Practice Location Address
First Line	:	2020 NORTH LOOP W STE 135
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77018-8142
Country	:	US
Telephone Number	:	281-524-6488
Fax Number	:

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

Provider Enumeration Date	:	08/28/2013
Last Update Date	:	08/13/2025

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