MEDICARE: MR. GALEN ELUMIR 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
1	225100000X	Physical Therapist	1081040	TX

General Provider Information

NPI Number	:	1538450275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GALEN ELUMIR PT

Provider Business Mailing Address
First Line	:	9903 AUTUMN LAKE TRL
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-3054
Country	:	US
Telephone Number	:	713-436-5834
Fax Number	:

Provider Business Practice Location Address
First Line	:	9903 AUTUMN LAKE TRL
Second Line	:
City	:	PEARLAND
State	:	TX
Zip	:	77584-3054
Country	:	US
Telephone Number	:	713-545-9002
Fax Number	:

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

Provider Enumeration Date	:	04/28/2011
Last Update Date	:	04/28/2011

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