Provider Demographics
NPI:1194524058
Name:AMIGO PEDIATRIC HOME THERAPY
Entity type:Organization
Organization Name:AMIGO PEDIATRIC HOME THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-577-2634
Mailing Address - Street 1:22542 SHADY WILLOW LN
Mailing Address - Street 2:
Mailing Address - City:PORTER
Mailing Address - State:TX
Mailing Address - Zip Code:77365-7125
Mailing Address - Country:US
Mailing Address - Phone:832-577-2634
Mailing Address - Fax:281-747-7440
Practice Address - Street 1:22542 SHADY WILLOW LN
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-7125
Practice Address - Country:US
Practice Address - Phone:832-577-2634
Practice Address - Fax:281-747-7440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty