Provider Demographics
NPI:1427249630
Name:ONDRUSEK PHYSICAL THERAPY, INC.
Entity type:Organization
Organization Name:ONDRUSEK PHYSICAL THERAPY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:ONDRUSEK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:281-980-3630
Mailing Address - Street 1:16103 LEXINGTON BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2385
Mailing Address - Country:US
Mailing Address - Phone:281-980-3630
Mailing Address - Fax:281-980-3632
Practice Address - Street 1:16103 LEXINGTON BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2385
Practice Address - Country:US
Practice Address - Phone:281-980-3630
Practice Address - Fax:281-980-3632
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-05
Last Update Date:2008-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1084119261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX659798OtherBLUE CROSS BLUE SHIELD