Provider Demographics
NPI:1811751175
Name:MATUS, TESSA (PT, DPT)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:
Last Name:MATUS
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 1:1647 HAROLD ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-3709
Mailing Address - Country:US
Mailing Address - Phone:512-658-3392
Mailing Address - Fax:
Practice Address - Street 1:4909 BISSONNET ST STE 115
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-4051
Practice Address - Country:US
Practice Address - Phone:832-463-1152
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1381446225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist