Provider Demographics
NPI:1629950555
Name:MERLET, JULIA GRACE PEISHAN (PTA)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:GRACE PEISHAN
Last Name:MERLET
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 FISH CREEK CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-6844
Mailing Address - Country:US
Mailing Address - Phone:409-790-1302
Mailing Address - Fax:
Practice Address - Street 1:450 WOODLAND SQUARE BLVD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384-2217
Practice Address - Country:US
Practice Address - Phone:936-235-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2187741225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant