MEDICARE: STEVE CUDDY MPT

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	1133577	TX

General Provider Information

NPI Number	:	1467517383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVE CUDDY MPT

Provider Business Mailing Address
First Line	:	4700 N CAPITAL OF TEXAS HWY
Second Line	:	#1220
City	:	AUSTIN
State	:	TX
Zip	:	78746-1118
Country	:	US
Telephone Number	:	512-769-9081
Fax Number	:

Provider Business Practice Location Address
First Line	:	7401 HWY 71, WEST
Second Line	:	#130
City	:	AUSTIN
State	:	TX
Zip	:	78735
Country	:	US
Telephone Number	:	512-288-2700
Fax Number	:

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

Provider Enumeration Date	:	12/22/2006
Last Update Date	:	07/08/2007

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