Most Relevant Information
Provider Data
| NPI Number: | 1003523804 |
| Provider Name: | ERIC BLAINE BALTODANO DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | 1329120 |
Most Important Dates
| Enumeration Date: | 11/01/2022 |
| Last Updated: | 11/02/2022 |
Provider Practice Location
13215 GRANT RD STE 900
CYPRESS
TX
774294094
Practice Location Phone/Fax
| Phone: | 8322209211 |
| Fax: | 8326102354 |
Provider Mailing Location
13215 GRANT RD STE 900
CYPRESS
TX
774294094
Provider Mailing Phone/Fax
| Phone: | 8322209211 |
| Fax: | 8326102354 |