Provider Demographics
NPI:1790019875
Name:HOUSE, GREGORY SCOTT (DPT)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOTT
Last Name:HOUSE
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:1737 WESTEND PL
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2252
Mailing Address - Country:US
Mailing Address - Phone:512-569-7309
Mailing Address - Fax:512-533-0003
Practice Address - Street 1:10222 PECAN PARK BLVD STE 4
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78729-1788
Practice Address - Country:US
Practice Address - Phone:512-569-7309
Practice Address - Fax:512-533-0003
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2021-08-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX11676732251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5522360001Medicare NSC