=====================================================
General NPI Number Information
=====================================================
NPI Number | 1932628716
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANIEL JOHN CURNUTT DPT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2017
-----------------------------------------------------
Last Update Date | 07/21/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3121 UNIVERSITY DR E STE 100
-----------------------------------------------------
City | BRYAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77802-3499
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-776-0169
-----------------------------------------------------
Fax | 979-776-1372
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3121 UNIVERSITY DR E STE 100
-----------------------------------------------------
City | BRYAN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77802-3499
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 979-776-0169
-----------------------------------------------------
Fax | 797-761-3729
-----------------------------------------------------
=====================================================
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 | 1274489
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------