MEDICARE: MAUREENE JAVIER

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
1	225100000X	Physical Therapist	6580	NV

General Provider Information

NPI Number	:	1104638758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MAUREENE JAVIER

Provider Business Mailing Address
First Line	:	9816 YELLOW CUP DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-1533
Country	:	US
Telephone Number	:	512-221-5578
Fax Number	:

Provider Business Practice Location Address
First Line	:	9816 YELLOW CUP DR
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-1533
Country	:	US
Telephone Number	:	512-221-5578
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/21/2025
Last Update Date	:	01/21/2025

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Directions to “ MAUREENE JAVIER ” Practice Location

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