Individual
ENGELBERT DIZON DE VERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5113 SPRING BROOK DR, CORPUS CHRISTI, TX 78413-5629
(361) 248-2004
(888) 499-1749
Mailing address
PO BOX 61160, CORPUS CHRISTI, TX 78466-1160
(361) 884-2904
(361) 884-2919
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1125821
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1125821
TEXAS BOARD OF PHYSICAL THERAPY EXAMINERS
TX
Enumeration date
01/08/2020
Last updated
01/08/2020
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