Provider Demographics
NPI:1619269388
Name:PERSONAL TOUCH THERAPY, LLC
Entity Type:Organization
Organization Name:PERSONAL TOUCH THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/SUPERVISING THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHONTAI
Authorized Official - Middle Name:MCMILLIAN
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MED CCC-SLP
Authorized Official - Phone:832-421-2527
Mailing Address - Street 1:480 N SAM HOUSTON PKWY E STE 124
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77060-3521
Mailing Address - Country:US
Mailing Address - Phone:713-510-5699
Mailing Address - Fax:832-932-1629
Practice Address - Street 1:480 N SAM HOUSTON PKWY E STE 124
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77060-3521
Practice Address - Country:US
Practice Address - Phone:713-510-5699
Practice Address - Fax:832-932-1629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-12
Last Update Date:2023-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102722235Z00000X
251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197606001Medicaid