Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 8332 | TX |
NPI | 1184849853 |
---|---|
Provider Name | Dr. Leo Anthony Vasquez |
First Address | Houston, TX 77084-5832 |
Second Address | Houston, TX 77084-5832 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 04/02/2014 |