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General NPI Number Information
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NPI Number | 1689916330
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Entity Type | Organization
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Legal Business Name | HUNTSVILLE PHYSICAL MEDICINE INSTITUTE PA
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Dates
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Enumeration Date | 03/20/2013
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Last Update Date | 10/01/2013
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Provider Practice Location Address
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Address Line | 901 NORMAL PARK DR SUITE 201
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City | HUNTSVILLE
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State | TX
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Zip | 77320-3770
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Country | US
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Telephone | 936-291-2111
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Fax | 936-291-0665
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Provider Business Mailing Address
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Address Line | 901 NORMAL PARK DR SUITE 201
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City | HUNTSVILLE
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State | TX
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Zip | 77320-3770
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Country | US
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Telephone | 936-291-2111
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Fax | 936-291-0665
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Authorized Official
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Title or Position | OWNER
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Name | ISNARDO E TREMOR
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Credential | MD
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Telephone | 936-291-2111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | K1707
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | K1707
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License Number State | TX
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