Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251P0200X | Physical Therapist - Pediatrics | 034509 | NY |
Y | 2251P0200X | Physical Therapist - Pediatrics | 1267018 | TX |
NPI | 1104194224 |
---|---|
Provider Name | Maria Bural |
First Address | Houston, TX 77007-1909 |
Second Address | Houston, TX 77007-1909 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/12/2011 |
Last Update Date | 07/11/2016 |