John David Paz, DPT

Individual provider Active NPI Physical Therapist · Holloman Afb, NM

NPI 1508536202 · NPPES record last updated Apr 5, 2025

Key facts

NPI
1508536202
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
PT015612 (GA)
Practice address
280 David L. Goldfein Street, BLDG 23,
Holloman Afb, NM 88330
Phone
(575) 572-0889
NPI assigned
Sep 15, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT015612GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Rehabilitation-Georgia Inc Past
since Oct 6, 2024
Accepting new patients
Matrix Rehabilitation-Georgia Inc Past
since Sep 1, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT015612 GA Yes

Addresses

Primary practice location

280 David L. Goldfein Street, BLDG 23,
Holloman Afb, NM 88330

Mailing address

280 1St St
Holloman Afb, NM 88330-7872

Other providers in Holloman Afb, NM

All providers in Holloman Afb, NM · Physical Therapist in New Mexico

Sources for this page

Verify at the official NPI Registry.