Provider Demographics
NPI:1548406564
Name:CLEVELAND PHYSICAL THERAPY LTD.
Entity Type:Organization
Organization Name:CLEVELAND PHYSICAL THERAPY LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JANNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:300 E HOUSTON ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-4554
Mailing Address - Country:US
Mailing Address - Phone:281-592-2884
Mailing Address - Fax:281-592-3269
Practice Address - Street 1:300 E HOUSTON ST
Practice Address - Street 2:SUITE A
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-4554
Practice Address - Country:US
Practice Address - Phone:281-592-2884
Practice Address - Fax:281-592-3269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-22
Last Update Date:2008-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4377230001Medicare NSC