Individual
JACKY THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6447 MAIN ST, HOUSTON, TX 77030-1502
(713) 790-3311
Mailing address
4163 GRIGGS RD, HOUSTON, TX 77021-1422
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2140559
TX
225200000X
Physical Therapy Assistant
Primary
54315
CA
Other
Enumeration date
08/22/2018
Last updated
02/10/2026
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