Individual
MR. EDGAR QUINAGORAN BACUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
4206 SOUTH FITZHUGH AVENUE, DALLAS, TX 75210
(214) 926-5319
(972) 412-4603
Mailing address
9710 BROADMOOR LANE, ROWLETT, TX 75089
(214) 206-6086
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1072247
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TXB104213
TXB104213
TX
Enumeration date
08/20/2008
Last updated
11/12/2010
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