Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | 2005252 | TX |
NPI | 1003297151 |
---|---|
Provider Name | Lee Buslett |
First Address | Houston, TX 77057-7036 |
Second Address | Houston, TX 77057-7036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2015 |
Last Update Date | 15/06/2015 |