Cody Brad Burrough, MPT
Physical Therapist in San Marcos, TX. Individual provider (NPI-1).
NPI number1841524626
StatusActive
Last updated in NPPESFeb 1, 2022
Details
- NPI
- 1841524626
- Entity type
- Individual (NPI-1)
- Name
- Cody Brad Burrough
- Credential
- MPT
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 25, 2009
- Certification date
- Feb 1, 2022
- Last updated
- Feb 1, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 1190479 | TX | Yes |
Practice location
1602 Aquarena Springs Dr Ste 101San Marcos, TX 78666-7268
Phone 512-667-9479 · Fax 512-717-3244
Mailing address
1602 Aquarena Springs Dr Ste 101San Marcos, TX 78666-7268
Phone 512-667-9479 · Fax 512-717-3244
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