Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 1233028 | TX |
NPI | 1285259747 |
---|---|
Provider Name | Mr. Eric Reyes |
First Address | Houston, TX 77006-1507 |
Second Address | Houston, TX 77004-8004 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/06/2020 |
Last Update Date | 10/06/2020 |