Provider Demographics
NPI:1265537559
Name:OZMENT, CHARLOTTE REX (PT)
Entity type:Individual
Prefix:MRS
First Name:CHARLOTTE
Middle Name:REX
Last Name:OZMENT
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 1:12817 GULF FWY
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77034-4807
Mailing Address - Country:US
Mailing Address - Phone:281-481-4100
Mailing Address - Fax:281-481-4105
Practice Address - Street 1:12817 GULF FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77034-4807
Practice Address - Country:US
Practice Address - Phone:281-481-4100
Practice Address - Fax:281-481-4105
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2012-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X
TX1510352251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T3146OtherBCBS PROVIDER #
TX107953504Medicaid