Individual
E. WADE LOUDAMY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
510 N HEWITT DR, HEWITT, TX 76643-3038
(254) 666-3666
Mailing address
PO BOX 847556, DALLAS, TX 75284-7556
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1131373
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1708497-02
—
TX
01
—
8T4560
BLUE SHIELD
TX
Enumeration date
04/08/2006
Last updated
07/11/2007
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