Provider Demographics
NPI:1801496740
Name:BRODSKY, IULIA (PT ASSISTANT)
Entity type:Individual
Prefix:MS
First Name:IULIA
Middle Name:
Last Name:BRODSKY
Suffix:
Gender:F
Credentials:PT ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4047 MT EVEREST WAY
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-0140
Mailing Address - Country:US
Mailing Address - Phone:832-231-2403
Mailing Address - Fax:
Practice Address - Street 1:4047 MT EVEREST WAY
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-0140
Practice Address - Country:US
Practice Address - Phone:832-231-2403
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2155746225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant