Provider Demographics
NPI:1235165598
Name:HOUNSHELL, TROY RAY (PT)
Entity Type:Individual
Prefix:
First Name:TROY
Middle Name:RAY
Last Name:HOUNSHELL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6015 76TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-1745
Mailing Address - Country:US
Mailing Address - Phone:806-748-0349
Mailing Address - Fax:806-748-0349
Practice Address - Street 1:3223 S LOOP 289
Practice Address - Street 2:STE 101
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1337
Practice Address - Country:US
Practice Address - Phone:806-792-5522
Practice Address - Fax:806-785-7582
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX168329401Medicaid
TX83687EMedicare ID - Type Unspecified