Provider Demographics
NPI:1942868625
Name:CORREA, JASIA (PT, DPT, CLT, CHN)
Entity Type:Individual
Prefix:DR
First Name:JASIA
Middle Name:
Last Name:CORREA
Suffix:
Gender:F
Credentials:PT, DPT, CLT, CHN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TEXAS CHILDREN'S HOSPITAL
Mailing Address - Street 2:6621 FANNIN ST
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:832-826-2135
Mailing Address - Fax:
Practice Address - Street 1:TEXAS CHILDREN'S HOSPITAL
Practice Address - Street 2:6621 FANNIN ST
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:832-826-2135
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1232802225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist