Provider Demographics
NPI:1619525110
Name:CROCHET, ZACHARY (PT)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:
Last Name:CROCHET
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 1:8448 SIEGEN LN
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70810-1938
Mailing Address - Country:US
Mailing Address - Phone:225-767-8182
Mailing Address - Fax:225-767-8757
Practice Address - Street 1:15200 SOUTHWEST FWY STE 130
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3863
Practice Address - Country:US
Practice Address - Phone:281-313-0090
Practice Address - Fax:866-912-7672
Is Sole Proprietor?:No
Enumeration Date:2019-08-28
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1319046225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist