Provider Demographics
NPI:1770927188
Name:HOLISTIC PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:HOLISTIC PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GISELA
Authorized Official - Middle Name:M
Authorized Official - Last Name:SITON
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:281-728-3430
Mailing Address - Street 1:17200 STATE HIGHWAY 249 STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064-1185
Mailing Address - Country:US
Mailing Address - Phone:281-728-3430
Mailing Address - Fax:
Practice Address - Street 1:17200 STATE HIGHWAY 249 STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064-1185
Practice Address - Country:US
Practice Address - Phone:281-728-3430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2014-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy