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General NPI Number Information
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NPI Number | 1205864212
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Entity Type | Individual
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Provider Name | RAFAEL PARDEIRO MSPT
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Gender | Male
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Dates
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Enumeration Date | 06/29/2006
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Last Update Date | 04/01/2020
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Provider Practice Location Address
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Address Line | 9501 ANCHUSA TRL
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City | AUSTIN
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State | TX
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Zip | 78736-2335
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Country | US
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Telephone | 512-626-2025
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Fax |
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Provider Business Mailing Address
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Address Line | 9501 ANCHUSA TRL
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City | AUSTIN
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State | TX
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Zip | 78736-2335
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Country | US
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Telephone | 512-461-1902
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1148408
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License Number State | TX
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