Provider Demographics
NPI:1700495728
Name:WOOTTON, EMILY BRIANNA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:BRIANNA
Last Name:WOOTTON
Suffix:
Gender:F
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 1:18842 FOX KESTREL TRL
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-6770
Mailing Address - Country:US
Mailing Address - Phone:832-286-8991
Mailing Address - Fax:
Practice Address - Street 1:920 MEDICAL PLAZA DR STE 270
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380-3259
Practice Address - Country:US
Practice Address - Phone:713-797-5942
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-27
Last Update Date:2021-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1333912225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist