Provider Demographics
NPI:1003405119
Name:PAEZ, GENE JR (DPT)
Entity Type:Individual
Prefix:DR
First Name:GENE
Middle Name:
Last Name:PAEZ
Suffix:JR
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 CARNOUSTY DR
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-3288
Mailing Address - Country:US
Mailing Address - Phone:210-542-5278
Mailing Address - Fax:
Practice Address - Street 1:17323 INTERSTATE 35 N
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1277
Practice Address - Country:US
Practice Address - Phone:210-659-4333
Practice Address - Fax:210-659-0809
Is Sole Proprietor?:No
Enumeration Date:2021-01-13
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1318752225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist