Provider Demographics
NPI:1215789003
Name:CINCOTTI, JOSEPH TYLER (PTA)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:TYLER
Last Name:CINCOTTI
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 CHELSEA BLVD APT 1605
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-6271
Mailing Address - Country:US
Mailing Address - Phone:352-484-4545
Mailing Address - Fax:
Practice Address - Street 1:4710 W BELLFORT AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-3434
Practice Address - Country:US
Practice Address - Phone:713-360-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2172706225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant