Provider Demographics
NPI:1033080684
Name:RUTOWSKI, TIMOTHY G
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:G
Last Name:RUTOWSKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 PINELOCH DR STE 600
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77062-2736
Mailing Address - Country:US
Mailing Address - Phone:281-461-6888
Mailing Address - Fax:866-237-5824
Practice Address - Street 1:1001 PINELOCH DR STE 600
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77062-2736
Practice Address - Country:US
Practice Address - Phone:281-461-6888
Practice Address - Fax:866-237-5824
Is Sole Proprietor?:No
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician