Provider Demographics
NPI:1033575840
Name:113015 THERAPY, PLLC
Entity Type:Organization
Organization Name:113015 THERAPY, PLLC
Other - Org Name:PEDIATRIC THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:KNOWLTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:713-772-1400
Mailing Address - Street 1:8323 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 101
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1615
Mailing Address - Country:US
Mailing Address - Phone:713-772-1400
Mailing Address - Fax:713-772-7116
Practice Address - Street 1:8323 SOUTHWEST FWY
Practice Address - Street 2:SUITE 101
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1615
Practice Address - Country:US
Practice Address - Phone:713-772-1400
Practice Address - Fax:713-772-7116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0008XAllopathic & Osteopathic PhysiciansPediatricsNeurodevelopmental DisabilitiesGroup - Multi-Specialty