Provider Demographics
NPI:1144407735
Name:RONNANDER, BREANNA GAYLE (MS, PT)
Entity Type:Individual
Prefix:
First Name:BREANNA
Middle Name:GAYLE
Last Name:RONNANDER
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11242 FM 1960 RD W
Mailing Address - Street 2:SUITE 104
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3630
Mailing Address - Country:US
Mailing Address - Phone:281-469-8163
Mailing Address - Fax:281-469-5559
Practice Address - Street 1:28341 TOMBALL PKWY
Practice Address - Street 2:STE 110
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375
Practice Address - Country:US
Practice Address - Phone:281-973-2197
Practice Address - Fax:832-871-4266
Is Sole Proprietor?:No
Enumeration Date:2008-01-25
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX1178160225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist