Provider Demographics
NPI:1790868768
Name:BATES, HOUSTON ONEAL (RPT)
Entity Type:Individual
Prefix:MR
First Name:HOUSTON
Middle Name:ONEAL
Last Name:BATES
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 244
Mailing Address - Street 2:1418 PATRICK ST.
Mailing Address - City:WAVERLY
Mailing Address - State:AL
Mailing Address - Zip Code:36879-0244
Mailing Address - Country:US
Mailing Address - Phone:334-501-8837
Mailing Address - Fax:
Practice Address - Street 1:245 CAHABA VALLEY PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-2216
Practice Address - Country:US
Practice Address - Phone:205-942-6820
Practice Address - Fax:205-942-5627
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4485225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-31616OtherBLUE CROSS BLUE SHIELD