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Contact Information

TINA OTTER, PHYSICAL THERAPIST
2956 I-45 NORTH
SUITE 500
CONROE, TX77303
 Phone: 936-441-4422
 Fax: 936-441-4427
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for TINA OTTER · (Female)

NPI # 1144239070
Status Active
Credentials PHYSICAL THERAPIST
Entity Individual
Enumeration date 08/07/2006
Last updated 09/08/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • TX License # 1148649
  • TX Other 8T0852 BLUE CROSS BLUE SHIELD
  • TX Other 00164S MEDICARE PROVIDER GROUP N
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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