Provider Demographics
NPI:1114616554
Name:MENARD, ABBEY ELAINE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ABBEY
Middle Name:ELAINE
Last Name:MENARD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 GEMINI ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77058-2806
Mailing Address - Country:US
Mailing Address - Phone:281-335-1111
Mailing Address - Fax:281-286-9250
Practice Address - Street 1:1045 GEMINI ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-2806
Practice Address - Country:US
Practice Address - Phone:281-335-1111
Practice Address - Fax:281-286-9250
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-02
Last Update Date:2023-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1371303225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist