Keitaro Abe, P.T.

Individual provider Active NPI Physical Therapist · Corpus Christi, TX

NPI 1659620722 · NPPES record last updated May 8, 2013

Key facts

NPI
1659620722
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
1220626 (TX)
Practice address
5026 Deepwood Cir
Corpus Christi, TX 78415-2901
Phone
(361) 854-2278
Fax
(361) 854-2389
NPI assigned
Sep 5, 2012
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)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1220626 TX Yes

Addresses

Primary practice location

5026 Deepwood Cir
Corpus Christi, TX 78415-2901

Mailing address

5026 Deepwood Cir
Corpus Christi, TX 78415-2901
Phone (361) 854-2278

Other identifiers

IdentifierTypeStateIssuer
879T68OtherTXBCBS
3139008-01MedicaidTX

Other providers in Corpus Christi, TX

All providers in Corpus Christi, TX · Physical Therapist in Texas

Sources for this page

Verify at the official NPI Registry.