Provider Demographics
NPI:1215118328
Name:UGHETTI, ANTHONY CHARLES (PTA, NHA)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:CHARLES
Last Name:UGHETTI
Suffix:
Gender:M
Credentials:PTA, NHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 KINGWOOD DR
Mailing Address - Street 2:APT. 721
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3707
Mailing Address - Country:US
Mailing Address - Phone:574-210-4367
Mailing Address - Fax:
Practice Address - Street 1:19424 MCKAY BLVD
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5706
Practice Address - Country:US
Practice Address - Phone:281-319-4060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMA-0550225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant