Provider Demographics
NPI:1336378256
Name:BERBEL, THERESA M (PT)
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:M
Last Name:BERBEL
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12777 ASHFORD POINT DR
Mailing Address - Street 2:STE. 2801
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-5900
Mailing Address - Country:US
Mailing Address - Phone:832-433-2585
Mailing Address - Fax:
Practice Address - Street 1:12777 ASHFORD POINT DR
Practice Address - Street 2:STE. 2801
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-5900
Practice Address - Country:US
Practice Address - Phone:832-433-2585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2010-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC01212171100000X
TX10671482251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAC01212OtherTEXAS STATE BOARD OF ACUPUNCTURE EXAMINERS
TX1067148OtherTEXAS PHYSICAL THERAPY LICENSE NUMBER