Provider Demographics
NPI:1972887503
Name:LILES, TROY (ATP)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:
Last Name:LILES
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2111 FM 1960 RD E
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-5229
Mailing Address - Country:US
Mailing Address - Phone:832-445-0956
Mailing Address - Fax:832-445-0958
Practice Address - Street 1:2111 FM 1960 RD E
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-5229
Practice Address - Country:US
Practice Address - Phone:832-445-0956
Practice Address - Fax:832-445-0958
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXATP48380225CA2400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225CA2400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation CounselorAssistive Technology Practitioner