| NPI | 1447625546 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADALBERTO REVELES Director 915-920-4047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1061430) |
| Additional Taxonomies | 2251G0304X Physical Therapist, Geriatrics (Licence: TX 1061430) |
| 2251P0200X Physical Therapist, Pediatrics (Licence: TX 1061430) | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: TX 1061430) | |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2021-11-09 |