Provider Demographics
NPI:1013117829
Name:ANG, DENYSIUS JOSE G
Entity type:Individual
Prefix:
First Name:DENYSIUS JOSE
Middle Name:G
Last Name:ANG
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 1:702 N ED CAREY DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-7914
Mailing Address - Country:US
Mailing Address - Phone:956-440-0609
Mailing Address - Fax:956-425-9840
Practice Address - Street 1:702 N ED CAREY DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-7914
Practice Address - Country:US
Practice Address - Phone:956-440-0609
Practice Address - Fax:956-425-9840
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-19
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1163130225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1163130OtherSTATE LICENSE