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General NPI Number Information
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NPI Number | 1902089535
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Entity Type | Individual
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Provider Name | VINCENT LEE ADAMS LPTA
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Gender | Male
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Dates
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Enumeration Date | 12/05/2007
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Last Update Date | 12/05/2007
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Provider Practice Location Address
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Address Line | 109 W TYLER ST SUITE E
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City | GILMER
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State | TX
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Zip | 75644-2239
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Country | US
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Telephone | 956-874-3004
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Fax |
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Provider Business Mailing Address
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Address Line | 7561 FM 1960 RD E SUITE 284
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City | HUMBLE
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State | TX
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Zip | 77346-3126
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Country | US
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Telephone | 956-874-3004
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2033082
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License Number State | TX
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