Provider Demographics
NPI:1164550695
Name:NUVAL, MARVIN PASCUA (PT)
Entity Type:Individual
Prefix:
First Name:MARVIN
Middle Name:PASCUA
Last Name:NUVAL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8703 BROADWAY ST STE 121
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8098
Mailing Address - Country:US
Mailing Address - Phone:281-412-7901
Mailing Address - Fax:281-412-7902
Practice Address - Street 1:8703 BROADWAY ST
Practice Address - Street 2:SUITE 121
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-8167
Practice Address - Country:US
Practice Address - Phone:281-412-7901
Practice Address - Fax:281-412-7902
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1121069225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist