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General NPI Number Information
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NPI Number | 1932624095
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Entity Type | Individual
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Provider Name | JOEL HOMERO OBREGON PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 08/10/2017
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Last Update Date | 08/10/2017
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Provider Practice Location Address
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Address Line | 6014 45TH ST
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City | LUBBOCK
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State | TX
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Zip | 79407-3773
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Country | US
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Telephone | 806-780-7433
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Fax | 806-780-7434
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Provider Business Mailing Address
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Address Line | 1727 W SAGE RD
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City | KINGSVILLE
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State | TX
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Zip | 78363-2696
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Country | US
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Telephone | 361-522-7401
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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 | 1293936
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License Number State | TX
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