| NPI | 1295807667 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS LU Owner 210-558-2058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X (Licence: TX 9318) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: TX 1169100) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2020-08-22 |