Provider Demographics
NPI:1114188315
Name:CARDELLINI, AYA (MPT)
Entity Type:Individual
Prefix:
First Name:AYA
Middle Name:
Last Name:CARDELLINI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 ROSE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-5532
Mailing Address - Country:US
Mailing Address - Phone:713-303-7672
Mailing Address - Fax:832-565-1445
Practice Address - Street 1:4611 ROSE ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007
Practice Address - Country:US
Practice Address - Phone:713-303-7672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2019-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1158897225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist