Provider Demographics
NPI:1245387000
Name:SIMON, RON (PT)
Entity Type:Individual
Prefix:
First Name:RON
Middle Name:
Last Name:SIMON
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:PO BOX 4396
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210-4396
Mailing Address - Country:US
Mailing Address - Phone:281-955-7577
Mailing Address - Fax:281-955-5875
Practice Address - Street 1:11800 FM 1960 RD W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3840
Practice Address - Country:US
Practice Address - Phone:281-955-7577
Practice Address - Fax:281-955-5875
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPT11431392251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPT1143139OtherLICENSE NUMBER