MEDICARE: MR. RUSSELL H PANGBORN PT

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	1084135	TX

General Provider Information

NPI Number	:	1376570770
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RUSSELL H PANGBORN PT

Provider Business Mailing Address
First Line	:	116 MEADOWLAKES DR
Second Line	:
City	:	MEADOWLAKES
State	:	TX
Zip	:	78654-6604
Country	:	US
Telephone Number	:	830-693-0145
Fax Number	:	830-693-0145

Provider Business Practice Location Address
First Line	:	2312 N HWY 281
Second Line	:
City	:	MARBLE FALLS
State	:	TX
Zip	:	78654-4360
Country	:	US
Telephone Number	:	830-693-9393
Fax Number	:	830-693-4097

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

Provider Enumeration Date	:	06/28/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1447337068 — STEPHANIE GANSCHOW PHARMD
Practice Location Address:

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax:

1669699492 — MAKE TODAY COUNT INC
Practice Location Address:

2312 N HWY 281
MARBLE FALLS, TX
78654-4360

Practice Phone: 830-693-0145
Practice Fax: 830-693-4097

1316910797 — MS. STEPHANIE MORGAN PA
Practice Location Address:

1660 JOHN ADAMS PKWY
IDAHO FALLS, ID
83401-4360

Practice Phone: 208-523-8844
Practice Fax: 208-529-8684

1679642037 — BRENDA J SHAW PA
Practice Location Address:

1660 JOHN ADAMS PKWY
IDAHO FALLS, ID
83401-4360

Practice Phone: 208-523-8844
Practice Fax: 208-529-8684

1003979352 — DR. CRAIG Z. HALL M.D.
Practice Location Address:

1660 JOHN ADAMS PKWY
IDAHO FALLS, ID
83401-4360

Practice Phone: 208-523-8844
Practice Fax: 208-529-8684

1992840326 — LIFE SPRING WOMENS CLINIC, P.A.
Practice Location Address:

1660 JOHN ADAMS PKWY
IDAHO FALLS, ID
83401-4360

Practice Phone: 208-523-8844
Practice Fax: 208-529-8684

Directions to “ MR. RUSSELL H PANGBORN PT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.