Individual
MR. JUAN JOSE FABIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1638 VZ 1803, GRAND SALINE, TX 75140-7514
(903) 962-7595
Mailing address
1638 VZ CR 1803, GRAND SALINE, TX 75140
(903) 275-8500
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2049040
TX
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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