Provider Demographics
NPI:1891949822
Name:MORTON, NIKKI (MPT)
Entity type:Individual
Prefix:
First Name:NIKKI
Middle Name:
Last Name:MORTON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 HARBORSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:KEMAH
Mailing Address - State:TX
Mailing Address - Zip Code:77565-2997
Mailing Address - Country:US
Mailing Address - Phone:713-907-1034
Mailing Address - Fax:281-538-4614
Practice Address - Street 1:411 HARBORSIDE WAY
Practice Address - Street 2:
Practice Address - City:KEMAH
Practice Address - State:TX
Practice Address - Zip Code:77565-2997
Practice Address - Country:US
Practice Address - Phone:713-907-1034
Practice Address - Fax:281-538-4614
Is Sole Proprietor?:No
Enumeration Date:2008-11-04
Last Update Date:2008-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1113678225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist