Provider Demographics
NPI:1013432079
Name:SPIEGEL, ASHLEY AMANDA (PT)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:AMANDA
Last Name:SPIEGEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 N POST OAK RD APT 1306
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-5434
Mailing Address - Country:US
Mailing Address - Phone:806-241-4646
Mailing Address - Fax:
Practice Address - Street 1:4854 BEECHNUT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-1604
Practice Address - Country:US
Practice Address - Phone:713-660-0663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-10
Last Update Date:2017-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1296251225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist