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NPI Code Detail

MEDICARE: MR. ANDRE FRANK FURTADO D.P.T

MEDICARE: MR. ANDRE FRANK FURTADO D.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
1225100000XPhysical Therapist1191972TX

General Provider Information

NPI Number : 1912209792
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ANDRE FRANK FURTADO D.P.T
Provider Business Mailing Address
First Line : 3003 N A ST
Second Line :
City : MIDLAND
State : TX
Zip : 79705-5304
Country : US
Telephone Number : 432-684-7755
Fax Number :
Provider Business Practice Location Address
First Line : 3003 N A ST
Second Line :
City : MIDLAND
State : TX
Zip : 79705-5304
Country : US
Telephone Number : 432-684-7755
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2010
Last Update Date : 11/29/2010

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