Provider Demographics
NPI:1891971180
Name:SHAMROCK PHYSICAL THERAPY
Entity Type:Organization
Organization Name:SHAMROCK PHYSICAL THERAPY
Other - Org Name:REHABILITATION SERVICES OF HOUSTON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:713-790-1221
Mailing Address - Street 1:2305 SAN FELIPE ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-3401
Mailing Address - Country:US
Mailing Address - Phone:713-790-1221
Mailing Address - Fax:713-520-5493
Practice Address - Street 1:133 W PARKWOOD AVE
Practice Address - Street 2:
Practice Address - City:FRIENDSWOOD
Practice Address - State:TX
Practice Address - Zip Code:77546-5420
Practice Address - Country:US
Practice Address - Phone:281-482-7380
Practice Address - Fax:281-482-0781
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty