Provider Demographics
NPI:1467517383
Name:CUDDY, STEVE (MPT)
Entity Type:Individual
Prefix:
First Name:STEVE
Middle Name:
Last Name:CUDDY
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 N CAPITAL OF TEXAS HWY
Mailing Address - Street 2:#1220
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-1118
Mailing Address - Country:US
Mailing Address - Phone:512-769-9081
Mailing Address - Fax:
Practice Address - Street 1:7401 HWY 71, WEST
Practice Address - Street 2:#130
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78735
Practice Address - Country:US
Practice Address - Phone:512-288-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1133577225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist