Healthcare Provider Details

I. General information

NPI: 1629788310
Provider Name (Legal Business Name): GIOVANNI B CUARESMA JR. PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2022
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14857 SOUTHWEST FWY
SUGAR LAND TX
77478-5016
US

IV. Provider business mailing address

16117 WALL ST
JERSEY VILLAGE TX
77040-1267
US

V. Phone/Fax

Practice location:
  • Phone: 281-242-8900
  • Fax: 281-242-0355
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1338505
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: