| Organization Name: | FUNCTIONAL THERAPEUTICS |
| NPI Number: | 1235488354 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JUVENTINO RUIZ (OWNER) |
| Mailing Address: | 616 Vida Santa St Alamo |
| State: | TX US |
| Postal Code: | 78516 |
| Phone Number: | 9565334390 |
| Fax Number: | 9565870245 |
| NPI Enumeration Date: | 09/05/2012 |
| NPI Last Update Date: | 09/05/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 111838 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Speech, Language and Hearing Service Providers |
| Taxonomy Classification: | Speech-Language Pathologist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A speech pathologist is a person qualified by a master |