Provider Demographics
NPI:1043382013
Name:JAROMAHUM, NICK (BSPT)
Entity Type:Individual
Prefix:MR
First Name:NICK
Middle Name:
Last Name:JAROMAHUM
Suffix:
Gender:M
Credentials:BSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9802 CAPE BREEZE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-3883
Mailing Address - Country:US
Mailing Address - Phone:862-222-4528
Mailing Address - Fax:
Practice Address - Street 1:9802 CAPE BREEZE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-3883
Practice Address - Country:US
Practice Address - Phone:862-222-4528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA08263002251X0800X
TX7000660225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic