Provider Demographics
NPI:1588844781
Name:PHILIP, SAJU (PT)
Entity Type:Individual
Prefix:MR
First Name:SAJU
Middle Name:
Last Name:PHILIP
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3915 GOLDEN SHORES DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-7619
Mailing Address - Country:US
Mailing Address - Phone:646-229-0127
Mailing Address - Fax:
Practice Address - Street 1:3915 GOLDEN SHORES DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-7619
Practice Address - Country:US
Practice Address - Phone:646-229-0127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1176470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist