Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 1130672 | TX |
N | 2251S0007X | Physical Therapist - Sports | 1130672 | TX |
NPI | 1184807182 |
---|---|
Provider Name | Kevin James Mchorse |
First Address | Austin, TX 78723-3077 |
Second Address | Austin, TX 78723-3077 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2007 |
Last Update Date | 18/02/2008 |