Provider Demographics
NPI:1063698348
Name:TECHNIK, TINA JEAN (PT)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:JEAN
Last Name:TECHNIK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11555 MAGNOLIA PKWY #140
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584
Mailing Address - Country:US
Mailing Address - Phone:281-724-8241
Mailing Address - Fax:713-343-6361
Practice Address - Street 1:11555 MAGNOLIA PKWY #140
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584
Practice Address - Country:US
Practice Address - Phone:281-724-8241
Practice Address - Fax:713-343-6361
Is Sole Proprietor?:No
Enumeration Date:2008-01-16
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1133783225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist