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General NPI Number Information
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NPI Number | 1326616426
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Entity Type | Individual
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Provider Name | MR. JOHN P O'DOWD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 09/19/2022
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Provider Practice Location Address
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Address Line | 1706 S LAMAR BLVD
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City | AUSTIN
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State | TX
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Zip | 78704-3326
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Country | US
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Telephone | 337-304-7554
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Fax |
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Provider Business Mailing Address
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Address Line | 901 SPRINGDALE RD APT 201
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City | AUSTIN
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State | TX
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Zip | 78702-4044
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Country | US
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Telephone |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 130873
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License Number State | TX
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