Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1151779 | TX |
N | 2251S0007X | Physical Therapist - Sports | 1151779 | TX |
N | 2251X0800X | Physical Therapist - Orthopedic | 1151779 | TX |
NPI | 1134273626 |
---|---|
Provider Name | Arthur G Mazuca |
First Address | Houston, TX 77095-1612 |
Second Address | Houston, TX 77030-2735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 24/01/2012 |