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General NPI Number Information
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NPI Number | 1558522219
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Entity Type | Individual
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Provider Name | LINDA S LONGORIA PT MA OCS
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Gender | Female
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Dates
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Enumeration Date | 06/24/2008
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Last Update Date | 04/10/2009
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Provider Practice Location Address
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Address Line | 1825 FORTVIEW RD STE 109
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City | AUSTIN
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State | TX
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Zip | 78704-7657
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Country | US
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Telephone | 512-892-5250
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Fax | 512-892-7183
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Provider Business Mailing Address
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Address Line | PO BOX 151132
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City | AUSTIN
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State | TX
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Zip | 78715-1132
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Country | US
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Telephone | 512-892-5250
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Fax | 512-892-7183
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 113902
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 602400000
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License Number State | TX
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