Provider Demographics
NPI:1760009096
Name:FRELS, VICTORIA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:FRELS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:TORI
Other - Middle Name:
Other - Last Name:FRELS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:6502 CALDER ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77007-2118
Mailing Address - Country:US
Mailing Address - Phone:830-459-5508
Mailing Address - Fax:
Practice Address - Street 1:1635 NORTH LOOP W
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-1532
Practice Address - Country:US
Practice Address - Phone:713-314-8476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1309425225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist