Provider Demographics
NPI:1477220861
Name:ORIGIN PHYSICAL THERAPY (FL), PLLC
Entity Type:Organization
Organization Name:ORIGIN PHYSICAL THERAPY (FL), PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:CATHERINE
Authorized Official - Last Name:CLAMPETT
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:214-536-5401
Mailing Address - Street 1:1321 UPLAND DR.
Mailing Address - Street 2:PMB 19899
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043
Mailing Address - Country:US
Mailing Address - Phone:310-479-2323
Mailing Address - Fax:
Practice Address - Street 1:12411 HYMEADOW DRIVE
Practice Address - Street 2:BUILDING 3 SUITE 3B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-1874
Practice Address - Country:US
Practice Address - Phone:512-335-9300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-24
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty