Provider Demographics
NPI:1407039951
Name:ALMODOVAR, EDUARDO (PT)
Entity type:Individual
Prefix:MR
First Name:EDUARDO
Middle Name:
Last Name:ALMODOVAR
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 143744
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78714-3744
Mailing Address - Country:US
Mailing Address - Phone:512-323-0802
Mailing Address - Fax:512-323-0803
Practice Address - Street 1:7817 ROCKWOOD LN
Practice Address - Street 2:STE 322
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-1106
Practice Address - Country:US
Practice Address - Phone:512-342-2200
Practice Address - Fax:512-342-0128
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2016-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11266392251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic