Provider Demographics
NPI:1760635965
Name:GROSSMAN, PAULA BROWN (PT)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:BROWN
Last Name:GROSSMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 GESSNER DR STE 160
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-3842
Mailing Address - Country:US
Mailing Address - Phone:713-690-7069
Mailing Address - Fax:713-690-7169
Practice Address - Street 1:2600 GESSNER DR STE 160
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-3842
Practice Address - Country:US
Practice Address - Phone:713-690-7069
Practice Address - Fax:713-690-7169
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020675225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist