Provider Demographics
NPI:1295194702
Name:ATLETA PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ATLETA PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-530-7539
Mailing Address - Street 1:11707 S SAM HOUSTON PKWY W
Mailing Address - Street 2:H
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-2344
Mailing Address - Country:US
Mailing Address - Phone:281-530-7539
Mailing Address - Fax:281-907-9539
Practice Address - Street 1:11707 S SAM HOUSTON PKWY W
Practice Address - Street 2:H
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-2344
Practice Address - Country:US
Practice Address - Phone:281-530-7539
Practice Address - Fax:281-907-9539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-12
Last Update Date:2016-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty