Provider Demographics
NPI:1366757114
Name:SUDBROOK, BRITTANY (PT)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:SUDBROOK
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 1:5923 BOGIE WAY
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77505-3040
Mailing Address - Country:US
Mailing Address - Phone:281-773-8352
Mailing Address - Fax:
Practice Address - Street 1:1120 NASA PKWY STE 320
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3366
Practice Address - Country:US
Practice Address - Phone:281-773-8352
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-17
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1192818225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist