Provider Demographics
NPI:1477373348
Name:BRAHMBHATT, JAY (PT)
Entity type:Individual
Prefix:
First Name:JAY
Middle Name:
Last Name:BRAHMBHATT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15591 CREEK BEND DR STE 201
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4657
Mailing Address - Country:US
Mailing Address - Phone:832-532-0144
Mailing Address - Fax:
Practice Address - Street 1:411 PARK GROVE DR STE 720
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-1577
Practice Address - Country:US
Practice Address - Phone:832-586-4201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1399674225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist