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NPI Code Detail

MEDICARE: RAYMOND TAN PTA

MEDICARE: RAYMOND TAN PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2072823TX

General Provider Information

NPI Number : 1063995520
Entity Type Code : Individual
Provider Name (Legal Business Name) : RAYMOND TAN PTA
Provider Business Mailing Address
First Line : 1341 BLALOCK RD
Second Line :
City : HOUSTON
State : TX
Zip : 77055-6427
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1341 BLALOCK RD
Second Line :
City : HOUSTON
State : TX
Zip : 77055-6427
Country : US
Telephone Number : 713-468-7821
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/11/2018
Last Update Date : 09/11/2018

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Directions to “ RAYMOND TAN PTA” Practice Location

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