Provider Demographics
NPI:1235410531
Name:VISTRO, ARLEEN J (PT)
Entity Type:Individual
Prefix:
First Name:ARLEEN
Middle Name:J
Last Name:VISTRO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1829 AUGUSTA DR
Mailing Address - Street 2:2
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-3143
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1829 AUGUSTA DR
Practice Address - Street 2:2
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-3143
Practice Address - Country:US
Practice Address - Phone:832-752-4987
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1066371225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist