Provider Demographics
NPI:1558955989
Name:TUTTLE, EMMA MARLENE (DPT)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:MARLENE
Last Name:TUTTLE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4707 SUMMER LN
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-2732
Mailing Address - Country:US
Mailing Address - Phone:828-310-3435
Mailing Address - Fax:
Practice Address - Street 1:6621 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2399
Practice Address - Country:US
Practice Address - Phone:832-824-1000
Practice Address - Fax:832-825-2301
Is Sole Proprietor?:No
Enumeration Date:2021-02-25
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP20181225100000X
TX1382496225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist