Colleen Spencer, PHYSICAL THERAPIST

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1010494 Issued in TX

Practice address

4500 Bissonnet St Ste 340
Bellaire, TX 77401-3009

Phone

(713) 838-9050

Fax

(713) 838-9098

NPI assigned

Jul 23, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465948800000",
    "number": "1083814644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1504 TEXAS AVE",
            "address_2": "P.O. BOX 4588",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778054588",
            "telephone_number": "979-822-6467",
            "fax_number": "979-821-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 BISSONNET ST STE 340",
            "city": "BELLAIRE",
            "state": "TX",
            "postal_code": "774013009",
            "telephone_number": "713-838-9050",
            "fax_number": "713-838-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCER",
        "first_name": "COLLEEN",
        "credential": "PHYSICAL THERAPIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-23",
        "last_updated": "2016-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1010494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1010494",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "062908102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Bellaire, TX
• Providers in Bellaire, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.