Provider Demographics
NPI:1922798776
Name:SURGEONER, EMILY KATHERINE (DPT)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:KATHERINE
Last Name:SURGEONER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 AUTUMN COVE CIR
Mailing Address - Street 2:
Mailing Address - City:FLEMING ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32003-3231
Mailing Address - Country:US
Mailing Address - Phone:904-524-1487
Mailing Address - Fax:
Practice Address - Street 1:23910 KATY FWY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1395
Practice Address - Country:US
Practice Address - Phone:281-500-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2251S0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports