Provider Demographics
NPI:1366702045
Name:TORRES, STEVEN PAUL (PTA)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:PAUL
Last Name:TORRES
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 CENTRAL PARK LN APT 108
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-4107
Mailing Address - Country:US
Mailing Address - Phone:979-446-1517
Mailing Address - Fax:
Practice Address - Street 1:2400 CENTRAL PARK LN APT 108
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-4107
Practice Address - Country:US
Practice Address - Phone:979-446-1517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-29
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4049111225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant