Provider Demographics
NPI:1184746182
Name:HOMAN, GEORGINA MARIE (MPT)
Entity type:Individual
Prefix:
First Name:GEORGINA
Middle Name:MARIE
Last Name:HOMAN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10948 NORA RD
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601-8493
Mailing Address - Country:US
Mailing Address - Phone:325-669-8840
Mailing Address - Fax:
Practice Address - Street 1:1393 AMBLER AVE
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-2215
Practice Address - Country:US
Practice Address - Phone:325-670-2490
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1138808225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist