Provider Demographics
NPI:1295215010
Name:PILLOW, CURTIS LEON JR (PTA)
Entity type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:LEON
Last Name:PILLOW
Suffix:JR
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3601 BUCKINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-5821
Mailing Address - Country:US
Mailing Address - Phone:936-645-5448
Mailing Address - Fax:
Practice Address - Street 1:1203 FM 1277
Practice Address - Street 2:
Practice Address - City:SAN AUGUSTINE
Practice Address - State:TX
Practice Address - Zip Code:75972-1635
Practice Address - Country:US
Practice Address - Phone:936-275-3412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2090885225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant