Provider Demographics
NPI:1518962455
Name:PYLES, JOHN SHELTON SR (MSPT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:SHELTON
Last Name:PYLES
Suffix:SR
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 BLUE CASTLE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77015-1512
Mailing Address - Country:US
Mailing Address - Phone:832-236-9694
Mailing Address - Fax:713-330-4203
Practice Address - Street 1:210 BLUE CASTLE LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77015-1512
Practice Address - Country:US
Practice Address - Phone:832-236-9694
Practice Address - Fax:713-330-4203
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-16
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11115322251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX611638Medicare UPIN