Provider Demographics
NPI:1245590561
Name:NADEAU, GEOFFREY (PT)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:
Last Name:NADEAU
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 1:246 STARLING CRK
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-7234
Mailing Address - Country:US
Mailing Address - Phone:512-709-3933
Mailing Address - Fax:
Practice Address - Street 1:246 STARLING CRK
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-7234
Practice Address - Country:US
Practice Address - Phone:512-709-3933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1188608225100000X
AR3458225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist