John Maxwell Todd, OT
Individual provider Active NPI Contractor · Caldwell, TX
NPI 1194923748 · NPPES record last updated Jan 4, 2016
Key facts
- NPI
- 1194923748
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Contractor 171W00000X
- License
- 109180 (TX)
- Practice address
- 1022 Presidential Corridor
Caldwell, TX 77836-4611 - Phone
- (979) 567-0920
- NPI assigned
- Jul 5, 2007
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109180 | TX | MD | Contractor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | 109180 | TX | Yes |
Addresses
Primary practice location
1022 Presidential Corridor
Caldwell, TX 77836-4611
Mailing address
8561 Old Reliance Rd
Bryan, TX 77808-8435
Phone (979) 820-1547
Other providers in Caldwell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 4, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.