Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1351851 | TX |
NPI | 1053083667 |
---|---|
Provider Name | Dr. Iago H Pinto |
First Address | Shenandoah, TX 77380-3899 |
Second Address | Shenandoah, TX 77380-3899 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/10/2021 |
Last Update Date | 12/10/2021 |