Provider Demographics
NPI:1720212434
Name:ABSOLUTE PHYSICAL THERAPY & FITNESS
Entity Type:Organization
Organization Name:ABSOLUTE PHYSICAL THERAPY & FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDRE
Authorized Official - Middle Name:L
Authorized Official - Last Name:HUU
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:281-589-8877
Mailing Address - Street 1:2301 S DAIRY ASHFORD ST
Mailing Address - Street 2:STE F
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5753
Mailing Address - Country:US
Mailing Address - Phone:281-589-8877
Mailing Address - Fax:281-589-3007
Practice Address - Street 1:2301 S DAIRY ASHFORD ST
Practice Address - Street 2:STE F
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-5753
Practice Address - Country:US
Practice Address - Phone:281-589-8877
Practice Address - Fax:281-589-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1170135261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX190718003Medicaid