Provider Demographics
NPI:1124130869
Name:MEMORIAL PEDIATRIC THERAPY ASSOCIATES, PC
Entity type:Organization
Organization Name:MEMORIAL PEDIATRIC THERAPY ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:FORSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:713-787-6600
Mailing Address - Street 1:10375 RICHMOND AVE STE 1340
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4298
Mailing Address - Country:US
Mailing Address - Phone:713-787-6600
Mailing Address - Fax:713-787-6601
Practice Address - Street 1:10375 RICHMOND AVE STE 1340
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-4298
Practice Address - Country:US
Practice Address - Phone:713-787-6600
Practice Address - Fax:713-787-6601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2025-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
No225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty
No261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech