Provider Demographics
NPI:1013100999
Name:GROMEK, ANDREW EUGENE (PTA)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:EUGENE
Last Name:GROMEK
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:ANDY
Other - Middle Name:
Other - Last Name:GROMEK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PTA
Mailing Address - Street 1:17270 RED OAK DR
Mailing Address - Street 2:200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2618
Mailing Address - Country:US
Mailing Address - Phone:281-880-1454
Mailing Address - Fax:281-880-1572
Practice Address - Street 1:17270 RED OAK DR
Practice Address - Street 2:100
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2618
Practice Address - Country:US
Practice Address - Phone:281-880-1454
Practice Address - Fax:281-880-1572
Is Sole Proprietor?:No
Enumeration Date:2007-08-23
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2037901225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant