Provider Demographics
NPI:1205205275
Name:PERRY, KEITH (DPT)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:PERRY
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9100 WESTHEIMER RD
Mailing Address - Street 2:APT 813
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-3567
Mailing Address - Country:US
Mailing Address - Phone:516-680-9677
Mailing Address - Fax:
Practice Address - Street 1:2500 FONDREN RD
Practice Address - Street 2:SUITE 302
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-2308
Practice Address - Country:US
Practice Address - Phone:832-252-8058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2015-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1266799225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist