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NPI Code Detail

MEDICARE: MARIVIC GELLA PT

MEDICARE: MARIVIC GELLA 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
1225100000XPhysical Therapist1075489TX

General Provider Information

NPI Number : 1891033775
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIVIC GELLA PT
Provider Business Mailing Address
First Line : 7806 GATEWAY BLVD E STE 100
Second Line :
City : EL PASO
State : TX
Zip : 79915-1806
Country : US
Telephone Number : 915-566-7584
Fax Number : 915-566-7682
Provider Business Practice Location Address
First Line : 7806 GATEWAY BLVD E STE 100
Second Line :
City : EL PASO
State : TX
Zip : 79915-1806
Country : US
Telephone Number : 915-566-7584
Fax Number : 915-566-7682
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2013
Last Update Date : 01/28/2013

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Directions to “ MARIVIC GELLA PT” Practice Location

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