Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 1311963 | TX |
N | 225100000X | Physical Therapist | PT29451 | CA |
N | 2251C2600X | Cardiopulmonary | PT29451 | CA |
N | 2251S0007X | Physical Therapist - Sports | PT29451 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT29451 |
NPI | 1285885178 |
---|---|
Provider Name | Mr. Michael Scott Francisco |
First Address | Conroe, TX 77385-8124 |
Second Address | Conroe, TX 77385 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2008 |
Last Update Date | 28/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1311963 | ECPTOTE (01) | TX |
29451 | PTB OF CALIFORNIA (01) | CA |