Provider Demographics
NPI:1164716312
Name:VANOOTEGHEM, TRENTON DONALD (DPT)
Entity type:Individual
Prefix:
First Name:TRENTON
Middle Name:DONALD
Last Name:VANOOTEGHEM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29615 FM 1093 RD STE 2
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441-3926
Mailing Address - Country:US
Mailing Address - Phone:281-533-0507
Mailing Address - Fax:281-533-0521
Practice Address - Street 1:29615 FM 1093 RD STE 2
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441-3926
Practice Address - Country:US
Practice Address - Phone:281-533-0507
Practice Address - Fax:281-533-0521
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1212963225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist