Provider Demographics
NPI:1508585431
Name:MINAVI, KEVIN BEHZAD (PT, DPT)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:BEHZAD
Last Name:MINAVI
Suffix:
Gender:M
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 1:11242 FM 1960 RD W STE 104
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3635
Mailing Address - Country:US
Mailing Address - Phone:281-469-8163
Mailing Address - Fax:281-469-5559
Practice Address - Street 1:11242 FM 1960 RD W STE 104
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3635
Practice Address - Country:US
Practice Address - Phone:281-469-8163
Practice Address - Fax:281-469-5559
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1366416225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist