Individual
CHARLY ROSS U LINGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1500 MEDICAL AVE, COLLEGE STATION, TX 77845-7986
(979) 272-1000
Mailing address
1205 PORTSMOUTH CT, COLLEGE STATION, TX 77845-8629
(956) 279-3344
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2132123
TX
Other
Enumeration date
08/23/2018
Last updated
08/23/2018
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