Provider Demographics
NPI:1609810688
Name:TEIXEIRA, JOSEPH J JR (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:J
Last Name:TEIXEIRA
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6388 W PORTLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80128-4521
Mailing Address - Country:US
Mailing Address - Phone:303-972-1353
Mailing Address - Fax:303-932-2600
Practice Address - Street 1:5920 S ESTES ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-8619
Practice Address - Country:US
Practice Address - Phone:303-932-2500
Practice Address - Fax:303-932-2600
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2052225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC465718Medicare PIN