Provider Demographics
NPI:1376382341
Name:AGUAYO, NOAH REEVE (PT, DPT)
Entity type:Individual
Prefix:
First Name:NOAH
Middle Name:REEVE
Last Name:AGUAYO
Suffix:
Gender:M
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 1:13010 KINGSTON POINT LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77047-2542
Mailing Address - Country:US
Mailing Address - Phone:828-244-2743
Mailing Address - Fax:
Practice Address - Street 1:14700 FM 2100 RD STE 4
Practice Address - Street 2:
Practice Address - City:CROSBY
Practice Address - State:TX
Practice Address - Zip Code:77532-9162
Practice Address - Country:US
Practice Address - Phone:281-328-8346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-21
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP23153225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist