IndividualActive
Edsel Ligutom, PT
NPI 1710854013 · Geriatric Physical Therapist · Waco, TX
Provider details
- NPI number
- 1710854013
- Entity type
- Individual
- Primary specialty
- Geriatric Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PT
- Sex
- Male
- Sole proprietor
- Yes
- License
- 1293040 (TX)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
1400 Lake Shore Dr
Waco, TX 76708-3718
Phone: (254) 753-0291
Approximate (ZIP-level) locationGet directions
Mailing address
2817 Sherco Rd
Lorena, TX 76655-4097
Registry dates
- Enumerated
- 2025-10-21
- Last updated
- 2025-10-21
- Certified
- 2025-10-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.