Provider Demographics
NPI:1609051267
Name:INNER LOOP PHYSICAL THERAPY
Entity type:Organization
Organization Name:INNER LOOP PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDONA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:713-942-9024
Mailing Address - Street 1:2990 RICHMOND AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3109
Mailing Address - Country:US
Mailing Address - Phone:713-942-9024
Mailing Address - Fax:713-942-9071
Practice Address - Street 1:2990 RICHMOND AVE STE 110
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3109
Practice Address - Country:US
Practice Address - Phone:713-942-9024
Practice Address - Fax:713-942-9071
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1035442261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy