Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | 1112605 | TX |
NPI | 1053524181 |
---|---|
Provider Name | Mr. James Allen Hardin |
First Address | Austin, TX 78746-1450 |
Second Address | Austin, TX 78746-1450 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 08/08/2007 |