Provider Demographics
NPI:1215313580
Name:SCOTT, TAD (PT, DPT)
Entity type:Individual
Prefix:
First Name:TAD
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 NORTH LOOP W STE 135
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-8105
Mailing Address - Country:US
Mailing Address - Phone:281-816-7891
Mailing Address - Fax:281-674-8276
Practice Address - Street 1:2020 NORTH LOOP W STE 135
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-8105
Practice Address - Country:US
Practice Address - Phone:281-816-7891
Practice Address - Fax:281-674-8276
Is Sole Proprietor?:No
Enumeration Date:2015-08-10
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1251919225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist