Provider Demographics
NPI:1487905170
Name:WHITESTONE PHYSICAL THERAPY LP
Entity type:Organization
Organization Name:WHITESTONE PHYSICAL THERAPY LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MEREDITH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, LAT
Authorized Official - Phone:512-260-9600
Mailing Address - Street 1:5120 WOODWAY DR
Mailing Address - Street 2:# 10001
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77056-1723
Mailing Address - Country:US
Mailing Address - Phone:713-572-9000
Mailing Address - Fax:
Practice Address - Street 1:715 DISCOVERY BLVD STE 411
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2417
Practice Address - Country:US
Practice Address - Phone:512-260-9600
Practice Address - Fax:512-260-9601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-21
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1487905170OtherBLUE CROSS BLUE SHIELD
TX1487905170Medicaid