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NPI Code Detail

MEDICARE: NILSA GRISEL ANDINO PT

MEDICARE: NILSA GRISEL ANDINO PT
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
1225100000XPhysical Therapist1169807TX

General Provider Information

NPI Number : 1144748021
Entity Type Code : Individual
Provider Name (Legal Business Name) : NILSA GRISEL ANDINO PT
Provider Business Mailing Address
First Line : 5701 SHERBROOKE AVE
Second Line :
City : EL PASO
State : TX
Zip : 79924-4121
Country : US
Telephone Number : 915-329-7712
Fax Number :
Provider Business Practice Location Address
First Line : 4601 HONDO PASS DR STE A
Second Line :
City : EL PASO
State : TX
Zip : 79904-1457
Country : US
Telephone Number : 915-545-3422
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2017
Last Update Date : 03/17/2018

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Directions to “ NILSA GRISEL ANDINO PT” Practice Location

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