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General NPI Number Information
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NPI Number | 1538979554
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Entity Type | Individual
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Provider Name | ISRAEL MALDONADO DPT
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Gender | Male
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Dates
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Enumeration Date | 01/11/2025
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Last Update Date | 01/11/2025
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Provider Practice Location Address
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Address Line | 15803 WINDERMERE DR
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City | PFLUGERVILLE
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State | TX
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Zip | 78660-2402
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Country | US
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Telephone | 512-647-1720
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Fax |
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Provider Business Mailing Address
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Address Line | 12345 LAMPLIGHT VILLAGE AVE APT 1121
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City | AUSTIN
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State | TX
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Zip | 78758-2568
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Country | US
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Telephone | 512-364-6416
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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 |
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License Number State |
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