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Organization
PTW ILLUM
Active
Organization
PTW ILLUM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAN NGUYEN (CMO)
(832) 744-9086
Entity
Organization
Contact information
Practice address
8570 KATY FWY STE 116, HOUSTON, TX 77024-1865
(832) 831-4188
Mailing address
5380 W 34TH ST # 306, HOUSTON, TX 77092-6626
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
12/03/2019
Last updated
12/03/2019
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