Individual
MR. JESUS CERVANTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
114 LANG RD, PORTLAND, TX 78374-2654
(361) 643-8243
Mailing address
5026 DEEPWOOD CIR, CORPUS CHRISTI, TX 78415-2901
(361) 854-2278
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2130195
TX
Other
Enumeration date
12/07/2022
Last updated
12/07/2022
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