MEDICARE: OWEE RAJESH MULAY

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	049007	NY

General Provider Information

NPI Number	:	1578254082
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OWEE RAJESH MULAY

Provider Business Mailing Address
First Line	:	421 STAUNTON DR
Second Line	:
City	:	LEANDER
State	:	TX
Zip	:	78641-5471
Country	:	US
Telephone Number	:	840-888-9050
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 W 38TH ST STE G4
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-1134
Country	:	US
Telephone Number	:	512-968-8825
Fax Number	:

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

Provider Enumeration Date	:	05/16/2023
Last Update Date	:	05/16/2023

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