Provider Demographics
NPI:1396146817
Name:BERCUTT PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:BERCUTT PHYSICAL THERAPY, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:A
Authorized Official - Last Name:BERCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:713-360-0300
Mailing Address - Street 1:5252 WESTCHESTER STREET
Mailing Address - Street 2:SUITE 255
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005
Mailing Address - Country:US
Mailing Address - Phone:713-360-0300
Mailing Address - Fax:713-661-0410
Practice Address - Street 1:5252 WESTCHESTER STREET
Practice Address - Street 2:SUITE 255
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005
Practice Address - Country:US
Practice Address - Phone:713-360-0300
Practice Address - Fax:713-661-0410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-16
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225100000X, 2251X0800X
TX1202510225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty