Provider Demographics
NPI:1972511269
Name:ELMS, CHAD A (PT)
Entity Type:Individual
Prefix:MR
First Name:CHAD
Middle Name:A
Last Name:ELMS
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 1:2020 NORTH LOOP W STE 135
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8142
Mailing Address - Country:US
Mailing Address - Phone:210-372-9600
Mailing Address - Fax:210-372-9923
Practice Address - Street 1:2020 NORTH LOOP W STE 135
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8142
Practice Address - Country:US
Practice Address - Phone:210-372-9600
Practice Address - Fax:210-372-9923
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2023-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1134427225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00285986OtherRAILROAD MEDICARE
TX86570TOtherBLUE CROSS BLUE SHIELD
TX063210102Medicaid
TX86570TOtherBLUE CROSS BLUE SHIELD