Provider Demographics
NPI:1801934641
Name:PIENTOK, COLETTE (PT)
Entity type:Individual
Prefix:
First Name:COLETTE
Middle Name:
Last Name:PIENTOK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3651 WESLAYAN ST STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-6638
Mailing Address - Country:US
Mailing Address - Phone:713-850-8472
Mailing Address - Fax:713-850-8472
Practice Address - Street 1:3651 WESLAYAN ST STE 110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-6638
Practice Address - Country:US
Practice Address - Phone:713-850-8472
Practice Address - Fax:713-850-8472
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1039410225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist