Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1054716 | TX |
NPI | 1003939174 |
---|---|
Provider Name | Dennis J Curnyn |
First Address | Fort Worth, TX 76107-7641 |
Second Address | Fort Worth, TX 76107-7641 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
80350T | BCBS PROVIDER NUMBER (01) | TX |