Provider Demographics
NPI:1790772481
Name:SWITZENBERG, JOHN JOSEPH (LPT)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JOSEPH
Last Name:SWITZENBERG
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 EDGEMERE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-3754
Mailing Address - Country:US
Mailing Address - Phone:806-293-3130
Mailing Address - Fax:806-293-3747
Practice Address - Street 1:2204 EDGEMERE DR
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-3754
Practice Address - Country:US
Practice Address - Phone:806-293-3130
Practice Address - Fax:806-293-3747
Is Sole Proprietor?:No
Enumeration Date:2005-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1071322225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX087739101Medicaid
TX659502OtherBLUE CROSS
TX650481Medicare ID - Type Unspecified