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General NPI Number Information
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NPI Number | 1275021875
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Entity Type | Individual
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Provider Name | DANIEL DENZLER MAT LAT ATC
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Gender | Male
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Dates
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Enumeration Date | 04/29/2018
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Last Update Date | 12/02/2020
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Provider Practice Location Address
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Address Line | 13755 MAIN ST
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City | HOUSTON
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State | TX
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Zip | 77035-5445
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Country | US
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Telephone | 713-556-3348
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Fax |
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Provider Business Mailing Address
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Address Line | 22631 COLONIAL PKWY APT 1305
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City | KATY
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State | TX
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Zip | 77449-4184
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Country | US
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Telephone | 346-561-4055
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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 | AT7116
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License Number State | TX
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