Provider Demographics
NPI:1669698080
Name:HOUSTON PHYSICAL MEDICINE ASSOCIATES P A
Entity type:Organization
Organization Name:HOUSTON PHYSICAL MEDICINE ASSOCIATES P A
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DINKER
Authorized Official - Middle Name:G
Authorized Official - Last Name:AMATYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-773-4348
Mailing Address - Street 1:6776 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 450
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-2107
Mailing Address - Country:US
Mailing Address - Phone:713-773-4348
Mailing Address - Fax:713-773-1948
Practice Address - Street 1:6776 SOUTHWEST FWY
Practice Address - Street 2:SUITE 400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2107
Practice Address - Country:US
Practice Address - Phone:713-272-8884
Practice Address - Fax:713-272-0898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-17
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00U52QMedicare PIN