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NPI Code Detail

MEDICARE: ROWENA T PICO PT

MEDICARE:   ROWENA T PICO  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 Therapist1073740TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11073740OTHERTXTX STATE BOARD OF PT

General Provider Information

NPI Number : 1912029356
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROWENA T PICO PT
Provider Business Mailing Address
First Line : 8302 N 22ND LN
Second Line :
City : MCALLEN
State : TX
Zip : 78504-5732
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1016 FORT HOOD AVE APT 2
Second Line :
City : EDINBURG
State : TX
Zip : 78539-3332
Country : US
Telephone Number : 956-383-1854
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2007
Last Update Date : 07/08/2007

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Directions to “ ROWENA T PICO PT” Practice Location

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