Provider Demographics
NPI:1053879700
Name:CARDOSO, EULER FREIRE (MYOFASCIAL THERAPIST)
Entity type:Individual
Prefix:
First Name:EULER
Middle Name:FREIRE
Last Name:CARDOSO
Suffix:
Gender:M
Credentials:MYOFASCIAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 DUNLAVY ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-1779
Mailing Address - Country:US
Mailing Address - Phone:832-443-0723
Mailing Address - Fax:
Practice Address - Street 1:2311 DUNLAVY ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-1779
Practice Address - Country:US
Practice Address - Phone:832-443-0723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108800225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX108800OtherTEXAS DEPT. OF STATE HEALTH SERVICES