Healthcare Provider Details

I. General information

NPI: 1922040427
Provider Name (Legal Business Name): JULIE HRACHOVY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 MILAM ST
COLUMBUS TX
78934-2443
US

IV. Provider business mailing address

109 SHULT DR # 206
COLUMBUS TX
78934-3015
US

V. Phone/Fax

Practice location:
  • Phone: 979-732-8280
  • Fax: 979-732-9740
Mailing address:
  • Phone: 979-732-8280
  • Fax: 979-732-9740

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1083616
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: