MEDICARE: MR. JOHNZEN BAHIA ENERIO P.T.

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	1174070	TX

General Provider Information

NPI Number	:	1588807200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHNZEN BAHIA ENERIO P.T.

Provider Business Mailing Address
First Line	:	501 TERRACE VIEW DR
Second Line	:
City	:	MCKINNEY
State	:	TX
Zip	:	75071-3714
Country	:	US
Telephone Number	:	214-562-7524
Fax Number	:

Provider Business Practice Location Address
First Line	:	6101 OHIO DR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75024-2720
Country	:	US
Telephone Number	:	972-468-6291
Fax Number	:	214-291-9882

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

Provider Enumeration Date	:	04/10/2009
Last Update Date	:	04/17/2009

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Directions to “ MR. JOHNZEN BAHIA ENERIO P.T.” Practice Location

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