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NPI Code Detail

MEDICARE: ELIZABETH DEL BOSQUE PTA

MEDICARE: ELIZABETH DEL BOSQUE 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 Assistant2083911TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12083911OTHERTXTEXAS BOARD OF PHYSICAL THERAPY

General Provider Information

NPI Number : 1386126969
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH DEL BOSQUE PTA
Provider Business Mailing Address
First Line : 4900 E SAM HOUSTON PKWY S
Second Line :
City : PASADENA
State : TX
Zip : 77505-1400
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4900 E SAM HOUSTON PKWY S
Second Line :
City : PASADENA
State : TX
Zip : 77505-1400
Country : US
Telephone Number : 281-998-0399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2018
Last Update Date : 08/30/2018

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Directions to “ ELIZABETH DEL BOSQUE PTA” Practice Location

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