| Northshore Aquatherapy | |
|
12655 Woodforest Blvd Ste 100, Houston, TX 77015-3575 | |
| (713) 455-2535 | |
| (713) 451-1411 |
| Full Name | Northshore Aquatherapy |
|---|---|
| Type | Facility |
| Speciality | Physical Therapist |
| Location | 12655 Woodforest Blvd Ste 100, Houston, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376670265 | NPI | - | NPPES |
| 328188800 | Other | TX | DOL |
| 0091KK | Other | TX | BC/ BS GRP # |
| 045155001 | Medicaid | TX | |
| CS4064 | Other | TX | MEDICARE RAILROAD |
| 350017778 | Other | TX | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111NX0800X | Chiropractor - Orthopedic | 2889 (Texas) | Secondary |
| 225100000X | Physical Therapist | 1013647 (Texas) | Primary |
| Provider Name | Richard T Davis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1992829113 PECOS PAC ID: 3072596626 Enrollment ID: I20040612000489 |
| Mailing Address | Practice Location Address |
|---|---|
| Northshore Aquatherapy 12655 Woodforest Blvd, Suite #100, Houston, TX 77015-3564 Ph: (713) 455-2535 | Northshore Aquatherapy 12655 Woodforest Blvd Ste 100, Houston, TX 77015-3575 Ph: (713) 455-2535 |
Mr. Ruben Isidro Bautista, LPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 7333 North Freeway #290, Metropolitan Physical Therapy, Houston, TX 77076 Phone: 713-691-7368 Fax: 713-691-0527 | |
Fariborz Nezamabadi, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 5868 Westheimer Rd # 211, Houston, TX 77057 Phone: 832-605-4487 | |
Vishal M Patel, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 13428 Bissonnet Street, Houston, TX 77083 Phone: 408-834-0888 | |
Marcille C Baumgartner, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6624 Fannin, Suite 2600, Houston, TX 77030 Phone: 713-790-1818 Fax: 713-790-7500 | |
Medirehab And Physical Therapy Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 8831 Long Point Rd, Suite 103, Houston, TX 77055 Phone: 713-365-9100 Fax: 713-365-9101 | |
Rachael Lynne Mervine, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1615 Hermann Dr, Unit 1112, Houston, TX 77004 Phone: 413-627-1239 | |
Marc Gardner, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 6213 Skyline Dr, #200, Houston, TX 77057 Phone: 713-880-4400 Fax: 713-869-8637 |