Provider Demographics
NPI:1245710755
Name:NUNEZ, ROEL (DPT)
Entity type:Individual
Prefix:
First Name:ROEL
Middle Name:
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12001 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7296
Mailing Address - Country:US
Mailing Address - Phone:713-434-3800
Mailing Address - Fax:713-434-3807
Practice Address - Street 1:12001 SHADOW CREEK PKWY
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7296
Practice Address - Country:US
Practice Address - Phone:713-434-3800
Practice Address - Fax:713-434-3807
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1296028225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist