Provider Demographics
NPI:1740618453
Name:WINTER PEDIATRIC THERAPY
Entity Type:Organization
Organization Name:WINTER PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SLP ASSISTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:MAGDA
Authorized Official - Middle Name:
Authorized Official - Last Name:CERPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-538-6734
Mailing Address - Street 1:9850 RICHMOND AVE APT 6207
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4552
Mailing Address - Country:US
Mailing Address - Phone:832-538-6734
Mailing Address - Fax:
Practice Address - Street 1:9850 RICHMOND AVENUE # 6207
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042
Practice Address - Country:US
Practice Address - Phone:832-538-6734
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-16
Last Update Date:2013-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)