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General NPI Number Information
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NPI Number | 1588188015
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Entity Type | Organization
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Legal Business Name | MOWORK PT PLLC
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Dates
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Enumeration Date | 07/26/2017
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Last Update Date | 07/26/2017
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Provider Practice Location Address
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Address Line | 1500 RESEARCH FOREST DR # 235
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City | SHENANDOAH
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State | TX
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Zip | 77381-4373
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Country | US
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Telephone | 281-507-1727
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Fax | 281-507-1727
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Provider Business Mailing Address
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Address Line | 4603 PRESERVE PARK DR
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City | SPRING
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State | TX
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Zip | 77389-1737
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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 | OWNER/OPERATOR
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Name | DR. JONATHAN RUZICKA
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Credential | DPT
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Telephone | 281-507-1727
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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 | 1249030
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License Number State | TX
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