Healthcare Provider Details

I. General information

NPI: 1346463809
Provider Name (Legal Business Name): JOSEPH L MEZA P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2007
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3000 INVINCIBLE CIR
LEAGUE CITY TX
77573-2956
US

IV. Provider business mailing address

PO BOX 1193
KEMAH TX
77565-1193
US

V. Phone/Fax

Practice location:
  • Phone: 281-334-2560
  • Fax: 281-238-8401
Mailing address:
  • Phone: 281-334-2560
  • Fax: 281-238-8401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number143867
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: