Provider Demographics
NPI:1790498947
Name:ENCORE PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ENCORE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SHAFEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DHUKA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:832-615-4865
Mailing Address - Street 1:1219 MUSEUM SQUARE DR STE 400
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-7056
Mailing Address - Country:US
Mailing Address - Phone:832-615-4865
Mailing Address - Fax:832-615-4866
Practice Address - Street 1:1219 MUSEUM SQUARE DR STE 400
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-7056
Practice Address - Country:US
Practice Address - Phone:832-615-4865
Practice Address - Fax:832-615-4866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-03
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty