Provider Demographics
NPI:1821484411
Name:PABANI, POONAM PRADIPKUMAR (PT)
Entity Type:Individual
Prefix:MISS
First Name:POONAM
Middle Name:PRADIPKUMAR
Last Name:PABANI
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 1:910 N HIGHWAY 146
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-2252
Mailing Address - Country:US
Mailing Address - Phone:281-837-7571
Mailing Address - Fax:281-837-7573
Practice Address - Street 1:910 N HIGHWAY 146
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-2252
Practice Address - Country:US
Practice Address - Phone:818-377-5712
Practice Address - Fax:281-837-7573
Is Sole Proprietor?:No
Enumeration Date:2015-04-09
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1306030225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist