Provider Demographics
NPI:1154786549
Name:LIND, AMY (PTA)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:LIND
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 1:1321 PARK BAYOU DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1507
Mailing Address - Country:US
Mailing Address - Phone:419-704-9375
Mailing Address - Fax:
Practice Address - Street 1:1321 PARK BAYOU DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-1507
Practice Address - Country:US
Practice Address - Phone:281-556-9200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-29
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPTA.10331225200000X
KYA03421225200000X
TX2117709225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant