=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740442128
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOSE ROEL CADENA JR. DPT, FAAOMPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2008
-----------------------------------------------------
Last Update Date | 05/23/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 931 S MCCOLL RD STE B
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-2936
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-329-1100
-----------------------------------------------------
Fax | 866-332-4835
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 931 S MCCOLL RD STE B
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-2936
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-329-1100
-----------------------------------------------------
Fax | 866-332-4835
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 1181296
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------