Provider Demographics
NPI:1164770772
Name:AGER, HALLIE B (PT, DPT)
Entity Type:Individual
Prefix:
First Name:HALLIE
Middle Name:B
Last Name:AGER
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 1:4000 WASHINGTON AVENUE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007
Mailing Address - Country:US
Mailing Address - Phone:713-861-2722
Mailing Address - Fax:713-861-1567
Practice Address - Street 1:4000 WASHINGTON AVENUE
Practice Address - Street 2:SUITE 302
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77007
Practice Address - Country:US
Practice Address - Phone:713-861-2722
Practice Address - Fax:713-861-1567
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1221105225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist