MEDICARE: CYNTHIA CARD PT, MOMT, OCS

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	1028728	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	86261T	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1952387482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA CARD PT, MOMT, OCS

Provider Business Mailing Address
First Line	:	3000 RICHMOND AVE
Second Line	:	SUITE 100
City	:	HOUSTON
State	:	TX
Zip	:	77098-3102
Country	:	US
Telephone Number	:	713-621-2486
Fax Number	:	713-621-2491

Provider Business Practice Location Address
First Line	:	3000 RICHMOND AVE
Second Line	:	SUITE 100
City	:	HOUSTON
State	:	TX
Zip	:	77098-3102
Country	:	US
Telephone Number	:	713-621-2486
Fax Number	:	713-621-2491

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

Provider Enumeration Date	:	12/16/2005
Last Update Date	:	06/24/2010

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