Provider Demographics
NPI:1730079757
Name:POWERS, MELINDA GRACE (PT, DPT)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:GRACE
Last Name:POWERS
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 1:12502 PEBBLE WAY CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-6855
Mailing Address - Country:US
Mailing Address - Phone:832-314-2048
Mailing Address - Fax:
Practice Address - Street 1:12502 PEBBLE WAY CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-6855
Practice Address - Country:US
Practice Address - Phone:832-314-2048
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1393494225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist