Provider Demographics
NPI:1831440239
Name:EXCEPTIONAL PEDIATRIC THERAPY LLC
Entity type:Organization
Organization Name:EXCEPTIONAL PEDIATRIC THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MS
Authorized Official - First Name:NEDRA
Authorized Official - Middle Name:G
Authorized Official - Last Name:WOODS
Authorized Official - Suffix:
Authorized Official - Credentials:CCC/SLP
Authorized Official - Phone:832-487-9872
Mailing Address - Street 1:9610 LONG POINT RD STE 355
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-4280
Mailing Address - Country:US
Mailing Address - Phone:832-487-9872
Mailing Address - Fax:832-487-9880
Practice Address - Street 1:9610 LONGPOINT RD
Practice Address - Street 2:STE 120
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055
Practice Address - Country:US
Practice Address - Phone:832-487-9872
Practice Address - Fax:832-487-9880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-25
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X, 2251P0200X, 225XP0200X
TX102041235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Multi-Specialty
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Multi-Specialty