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General NPI Number Information
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NPI Number | 1164838330
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Entity Type | Individual
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Provider Name | URIAH MYRIE ATC
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Gender | Male
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Dates
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Enumeration Date | 07/08/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2 NRG PARK
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City | HOUSTON
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State | TX
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Zip | 77054-1573
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Country | US
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Telephone | 832-667-2301
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Fax |
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Provider Business Mailing Address
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Address Line | 403 GREENHILL CT
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City | ALBANY
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State | NY
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Zip | 12203-5618
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Country | US
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Telephone | 518-577-7524
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 002197
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License Number State | NY
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