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General NPI Number Information
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NPI Number | 1508942335
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Entity Type | Individual
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Provider Name | MICHAEL BEDOLLA PT
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Gender | Male
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 729 N 77 SUNSHINE STRIP
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City | HARLINGEN
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State | TX
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Zip | 78550-8847
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Country | US
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Telephone | 956-421-4667
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Fax | 956-421-2016
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Provider Business Mailing Address
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Address Line | 505 E WOOD AVE
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City | RAYMONDVILLE
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State | TX
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Zip | 78580-3161
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Country | US
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Telephone | 956-689-6601
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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 | 1170270
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License Number State | TX
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