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Individual
MYLA QUIBEN
Active
Individual
MYLA QUIBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1198953
TX
2251G0304X
Geriatric Physical Therapist
1198953
TX
2251N0400X
Neurology Physical Therapist
1198953
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
343396301
—
TX
01
—
8TAC71
BCBS
TX
Enumeration date
12/03/2010
Last updated
06/11/2015
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