Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 1268945 | TX |
NPI | 1073979381 |
---|---|
Provider Name | Marcus Knox |
First Address | Pearland, TX 77584-3687 |
Second Address | Houston, TX 77054-4803 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2016 |
Last Update Date | 20/11/2020 |