Provider Demographics
NPI:1427378801
Name:DICE, JENIFER (PT, SCD, PCS, COMT)
Entity Type:Individual
Prefix:
First Name:JENIFER
Middle Name:
Last Name:DICE
Suffix:
Gender:F
Credentials:PT, SCD, PCS, COMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15400 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3875
Mailing Address - Country:US
Mailing Address - Phone:832-828-1845
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2399
Practice Address - Country:US
Practice Address - Phone:832-824-1000
Practice Address - Fax:832-825-2301
Is Sole Proprietor?:No
Enumeration Date:2010-06-08
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1126126225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist