Healthcare Provider Details

I. General information

NPI: 1528259199
Provider Name (Legal Business Name): RICHARD GOCHIS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 08/07/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

209 SPEIGHT AVE FL 2
WACO TX
76706-1507
US

IV. Provider business mailing address

PO BOX 5199
ABILENE TX
79608-5199
US

V. Phone/Fax

Practice location:
  • Phone: 254-710-1010
  • Fax: 254-710-2499
Mailing address:
  • Phone: 325-437-8300
  • Fax: 325-437-8390

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1127256
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: