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General NPI Number Information
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NPI Number | 1447870753
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Entity Type | Organization
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Legal Business Name | CLOVERLEAF SERVICES, INC
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Dates
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Enumeration Date | 04/16/2020
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Last Update Date | 04/22/2020
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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 | 512-461-1902
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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 | VICE PRESIDENT
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Name | RAFAEL PARDEIRO
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Credential | MSPT
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Telephone | 512-461-1902
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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