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General NPI Number Information
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NPI Number | 1790995892
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Entity Type | Organization
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Legal Business Name | WAYNE C DODD
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 09/11/2013
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Provider Practice Location Address
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Address Line | 495 AMELIA EARHART STE B
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City | BROWNSVILLE
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State | TX
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Zip | 78521
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Country | US
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Telephone | 956-546-7777
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Fax | 956-546-8899
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Provider Business Mailing Address
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Address Line | 495 AMELIA EARHART DR STE B
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City | BROWNSVILLE
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State | TX
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Zip | 78521-5771
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Country | US
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Telephone | 956-546-7777
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Fax | 956-546-8899
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Authorized Official
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Title or Position | OWNER
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Name | WAYNE C DODD
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Credential | PT
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Telephone | 956-546-7777
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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 | 1064996
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License Number State | TX
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