Basic Information
Provider Information
NPI: 1750602454
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOEWS
FirstName: SAMANTHA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: (P.T)
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5771 ENID ST
Address2:  
City: HOUSTON
State: TX
PostalCode: 770091208
CountryCode: US
TelephoneNumber: 7138804400
FaxNumber: 7138698637
Practice Location
Address1: 6333 FOREST PARK RD STE A270
Address2:  
City: DALLAS
State: TX
PostalCode: 752355488
CountryCode: US
TelephoneNumber: 2143509800
FaxNumber: 2143509802
Other Information
ProviderEnumerationDate: 06/16/2010
LastUpdateDate: 06/16/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X1196150TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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