Provider Demographics
NPI:1306473954
Name:DOVAHEIGHTS PHYSICAL THERAPY & WELLNESS LLC
Entity type:Organization
Organization Name:DOVAHEIGHTS PHYSICAL THERAPY & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:UZOAMAKA
Authorized Official - Middle Name:CHIKA
Authorized Official - Last Name:EKPEMU
Authorized Official - Suffix:
Authorized Official - Credentials:PT, MPT
Authorized Official - Phone:682-208-9856
Mailing Address - Street 1:14823 GRAND CORRAL LN
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-2698
Mailing Address - Country:US
Mailing Address - Phone:682-208-9856
Mailing Address - Fax:
Practice Address - Street 1:14823 GRAND CORRAL LN
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-2698
Practice Address - Country:US
Practice Address - Phone:682-208-9856
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-24
Last Update Date:2020-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty