Healthcare Provider Details

I. General information

NPI: 1649265802
Provider Name (Legal Business Name): JOE ONOFRE L.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/14/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 S SUNSET AVE SUITE B
LITTLEFIELD TX
79339-4899
US

IV. Provider business mailing address

1506 S SUNSET AVE SUITE B
LITTLEFIELD TX
79339-4899
US

V. Phone/Fax

Practice location:
  • Phone: 806-385-3746
  • Fax: 806-385-6176
Mailing address:
  • Phone: 806-385-3746
  • Fax: 806-385-6176

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1027464
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: