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General NPI Number Information
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NPI Number | 1003413592
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Entity Type | Individual
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Provider Name | RAYMOND BRYAN RUWALDT II OTR
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Gender | Male
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Dates
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Enumeration Date | 10/07/2020
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Last Update Date | 10/07/2020
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Provider Practice Location Address
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Address Line | 777 N POST OAK RD
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City | HOUSTON
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State | TX
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Zip | 77024-3800
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Country | US
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Telephone | 713-956-0870
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Fax |
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Provider Business Mailing Address
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Address Line | 9210 N ALLEGRO ST
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City | HOUSTON
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State | TX
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Zip | 77080-5520
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Country | US
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Telephone | 713-732-1670
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 110011
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License Number State | TX
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