Provider Demographics
NPI:1932719697
Name:MIGLIANO, PEDRO (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:
Last Name:MIGLIANO
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7113 BRICK SLOPE PATH
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-8713
Mailing Address - Country:US
Mailing Address - Phone:281-750-6435
Mailing Address - Fax:
Practice Address - Street 1:747 HIGHWAY 71 W STE B200
Practice Address - Street 2:
Practice Address - City:BASTROP
Practice Address - State:TX
Practice Address - Zip Code:78602-4096
Practice Address - Country:US
Practice Address - Phone:512-920-6512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-06
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1321454225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist