Organization
PHYSICAL THERAPY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE L WILLIAMS (OFFICE MANAGER)
(936) 294-0283
Entity
Organization
Contact information
Practice address
127 MEDICAL PARK LN, HUNTSVILLE, TX 77340-4972
(936) 294-0283
(936) 294-9878
Mailing address
127 MEDICAL PARK LN, HUNTSVILLE, TX 77340-4972
(936) 294-0283
(936) 294-9878
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
640210000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85643T
BLUE CROSS BLUE SHIELD
TX
Enumeration date
05/05/2008
Last updated
05/22/2008
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