Individual
ENRIQUE VILLARUEL CADAYONA III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
4825 WELLESLEY AVE, FORT WORTH, TX 76107-6148
(817) 732-6608
Mailing address
4825 WELLESLEY AVE, FORT WORTH, TX 76107-6148
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1072403
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001028825
—
TX
Enumeration date
08/31/2018
Last updated
08/31/2018
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