Doctor Name: | JUVENAL ERIC CHACON |
NPI Number: | 1770974842 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, DPT |
License Number: | 1254951 |
Business Practice Address: | 3645 N Beach St Ft Worth, TX - 761373242 |
Business Phone Number: | 8177590004 |
Business Fax Number: | 8147590003 |
Mailing Address: | 3645 N Beach St, FT WORTH |
State: | TX |
Postal Code: | 761373242 |
Phone Number: | 8177590004 |
Fax Number: | 8177590003 |
NPI Enumeration Date: | 02/11/2015 |
NPI Last Update Date: | 02/11/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 1254951 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |