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General NPI Number Information
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NPI Number | 1760118269
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Entity Type | Individual
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Provider Name | JUSTIN WALKER PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 07/27/2022
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Last Update Date | 07/27/2022
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Provider Practice Location Address
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Address Line | 220 N 17TH ST
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City | NEDERLAND
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State | TX
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Zip | 77627-5029
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Country | US
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Telephone | 409-724-2391
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Fax |
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Provider Business Mailing Address
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Address Line | 220 N 17TH ST
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City | NEDERLAND
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State | TX
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Zip | 77627-5029
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Country | US
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Telephone | 409-718-8050
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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 | 1247386
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License Number State | TX
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