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Individual

TRISTAN T TANO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1681 HICKORY LOOP, LAS CRUCES, NM 88005-6587
(575) 647-3773
Mailing address
301 PERKINS DR STE B, LAS CRUCES, NM 88005-3248
(575) 647-3773

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
1201897
TX
225100000X
Physical Therapist
Primary
PT4930
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149984001
TX
05
207164901
TX
Enumeration date
12/06/2010
Last updated
04/13/2026
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