MEDICARE: MRS. IRIS G DOWNING P.T.

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	1078707	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8T6214	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1952310260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. IRIS G DOWNING P.T.

Provider Business Mailing Address
First Line	:	4782 BEECHNUT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-1637
Country	:	US
Telephone Number	:	713-349-8200
Fax Number	:	713-349-9810

Provider Business Practice Location Address
First Line	:	4782 BEECHNUT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77096-1637
Country	:	US
Telephone Number	:	713-349-8200
Fax Number	:	713-349-9810

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

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	10/26/2007

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