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Individual

MS. LINDA S LONGORIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT MA OCS

Contact information

Practice address
1825 FORTVIEW RD, STE 109, AUSTIN, TX 78704-7657
(512) 892-5250
(512) 892-7183
Mailing address
PO BOX 151132, AUSTIN, TX 78715-1132
(512) 892-5250
(512) 892-7183

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
113902
TX
2251X0800X
Orthopedic Physical Therapist
602400000
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0018DZ
BCBS GROUP #
TX
01
177242900
DEPARTMENT OF LABOR
TX
01
83661T
BCBS
TX
Enumeration date
06/24/2008
Last updated
04/10/2009
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