Provider Demographics
NPI:1124632278
Name:AMIN, PRIYANKA (PT)
Entity type:Individual
Prefix:
First Name:PRIYANKA
Middle Name:
Last Name:AMIN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:PRIYANKABEN
Other - Middle Name:
Other - Last Name:PATEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:20203 PERALTA CLIFF TRL
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77407-2065
Mailing Address - Country:US
Mailing Address - Phone:484-753-9676
Mailing Address - Fax:
Practice Address - Street 1:1921 S MASON RD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-6258
Practice Address - Country:US
Practice Address - Phone:281-394-4591
Practice Address - Fax:346-888-0981
Is Sole Proprietor?:No
Enumeration Date:2020-09-06
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13303512251G0304X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics