MEDICARE: MR. RICKY ASHTON CAIN LPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1144574	TX

General Provider Information

NPI Number	:	1336273895
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RICKY ASHTON CAIN LPT

Provider Business Mailing Address
First Line	:	3005 S LAMAR BLVD
Second Line	:	STE D-112
City	:	AUSTIN
State	:	TX
Zip	:	78704-8864
Country	:	US
Telephone Number	:	512-441-1240
Fax Number	:	512-441-3762

Provider Business Practice Location Address
First Line	:	3005 S LAMAR BLVD
Second Line	:	STE D-112
City	:	AUSTIN
State	:	TX
Zip	:	78704-8864
Country	:	US
Telephone Number	:	512-441-1240
Fax Number	:	512-441-3762

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/15/2007
Last Update Date	:	07/08/2007

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