Provider Demographics
NPI:1104107002
Name:ARCENEAX-HUMPHREY, NORMA (PTA)
Entity type:Individual
Prefix:
First Name:NORMA
Middle Name:
Last Name:ARCENEAX-HUMPHREY
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 1/2 E HIGHWAY 90
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:TX
Mailing Address - Zip Code:77535-2630
Mailing Address - Country:US
Mailing Address - Phone:281-424-7557
Mailing Address - Fax:281-424-7567
Practice Address - Street 1:3818 DECKER DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-1662
Practice Address - Country:US
Practice Address - Phone:281-424-7557
Practice Address - Fax:281-424-7567
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2007803225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant