Provider Demographics
NPI:1841584620
Name:WAUGH, TIMOTHY F (PT)
Entity Type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:F
Last Name:WAUGH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9334 SPELLMAN RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-2227
Mailing Address - Country:US
Mailing Address - Phone:281-467-5683
Mailing Address - Fax:713-270-7307
Practice Address - Street 1:9334 SPELLMAN RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-2227
Practice Address - Country:US
Practice Address - Phone:281-467-5683
Practice Address - Fax:713-270-7307
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1087948225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist