| NPI | 1447687918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK RUELAS Owner 210-723-6991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: TX 1152056) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: TX 113117) |
| 235Z00000X Speech-Language Pathologist, (Licence: TX 101342) | |
| Enumeration Date | 2013-09-30 |
| Last Update Date | 2013-09-30 |