Provider Demographics
NPI:1790368348
Name:REAMICO, EUGENE TIAUSAS
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:TIAUSAS
Last Name:REAMICO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24026 ADOBE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77493-2931
Mailing Address - Country:US
Mailing Address - Phone:832-348-7298
Mailing Address - Fax:
Practice Address - Street 1:24026 ADOBE RIDGE LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77493-2931
Practice Address - Country:US
Practice Address - Phone:832-348-7298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-02
Last Update Date:2021-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2099633225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant