Provider Demographics
NPI:1255814877
Name:OFIELD, ELLEN VILLANUEVA (PT)
Entity type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:VILLANUEVA
Last Name:OFIELD
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 1:1341 BLALOCK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6427
Mailing Address - Country:US
Mailing Address - Phone:832-657-8363
Mailing Address - Fax:713-496-1811
Practice Address - Street 1:1341 BLALOCK RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-6427
Practice Address - Country:US
Practice Address - Phone:832-657-8363
Practice Address - Fax:713-496-1811
Is Sole Proprietor?:No
Enumeration Date:2018-09-10
Last Update Date:2018-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1071470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist