Provider Demographics
NPI:1992303309
Name:COLAS, GAMAELLE (PTA)
Entity type:Individual
Prefix:
First Name:GAMAELLE
Middle Name:
Last Name:COLAS
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 1:17314 SH 249
Mailing Address - Street 2:UNIT 230
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77064
Mailing Address - Country:US
Mailing Address - Phone:171-376-6384
Mailing Address - Fax:
Practice Address - Street 1:17314 SH 249
Practice Address - Street 2:UNIT 230
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77064
Practice Address - Country:US
Practice Address - Phone:171-376-6384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2157518225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant