Provider Demographics
NPI:1477928406
Name:O'CONNOR, COLLEEN (PT, DPT)
Entity Type:Individual
Prefix:
First Name:COLLEEN
Middle Name:
Last Name:O'CONNOR
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 TOWNHURST DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-2811
Mailing Address - Country:US
Mailing Address - Phone:713-522-8880
Mailing Address - Fax:
Practice Address - Street 1:1750 TOWNHURST DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-2811
Practice Address - Country:US
Practice Address - Phone:713-522-8880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-02
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1292008225100000X
NY039645-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist