Provider Demographics
NPI:1184090110
Name:FORD, TASHA RENEE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:TASHA
Middle Name:RENEE
Last Name:FORD
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9771 RAMBLING TRL
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-1221
Mailing Address - Country:US
Mailing Address - Phone:979-415-4476
Mailing Address - Fax:
Practice Address - Street 1:3801 VISTA RD
Practice Address - Street 2:SUITE 200
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-2159
Practice Address - Country:US
Practice Address - Phone:713-910-5437
Practice Address - Fax:713-910-5445
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12626512251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics