MEDICARE: MR. RODOLFO OCEJO

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	235Z00000X	Speech-Language Pathologist	102314	TX
2	2251P0200X	Pediatric Physical Therapist	1202948	TX
3	2251G0304X	Geriatric Physical Therapist	1202948	TX
4	2251N0400X	Neurology Physical Therapist	1202948	TX
5	2251X0800X	Orthopedic Physical Therapist	1202948	TX
6	2251S0007X	Sports Physical Therapist	1202948	TX
7	225100000X	Physical Therapist	1202948	TX

General Provider Information

NPI Number	:	1427259811
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RODOLFO OCEJO

Provider Business Mailing Address
First Line	:	725 SOMERSET LANDING LN
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-4764
Country	:	US
Telephone Number	:	281-772-1250
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 SOMERSET LANDING LN
Second Line	:
City	:	LEAGUE CITY
State	:	TX
Zip	:	77573-4764
Country	:	US
Telephone Number	:	281-772-1250
Fax Number	:

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

Provider Enumeration Date	:	05/31/2007
Last Update Date	:	10/30/2015

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Directions to “ MR. RODOLFO OCEJO ” Practice Location

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