Mr Edsel Ligutom Jr, PT - Physical Therapist in Waco, TX

Mr Edsel Ligutom Jr, PT is a Physical Therapist - Geriatrics based in Waco, Texas. Mr Edsel Ligutom Jr is licensed to practice in Texas (license number 1293040) and his current practice location is 1400 Lake Shore Dr, Waco, Texas. He can be reached at his office (for appointments etc.) via phone at (254) 753-0291.

NPI number for Mr Edsel Ligutom Jr is 1710854013 and his current mailing address is 2817 Sherco Rd, Lorena, Texas. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1710854013.

Contact Information

Mr Edsel Ligutom Jr, PT
1400 Lake Shore Dr,
Waco, TX 76708-3718
(254) 753-0291
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameMr Edsel Ligutom Jr
GenderMale
SpecialityPhysical Therapist - Geriatrics
Location1400 Lake Shore Dr, Waco, Texas
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1710854013
  • Provider Enumeration Date: 10/21/2025
  • Last Update Date: 10/21/2025

Medical Identifiers

Medical identifiers for Mr Edsel Ligutom Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1710854013NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2251G0304XPhysical Therapist - Geriatrics 1293040 (Texas)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Edsel Ligutom Jr is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mr Edsel Ligutom Jr, PT
2817 Sherco Rd,
Lorena, TX 76655-4097

Ph: () -
Mr Edsel Ligutom Jr, PT
1400 Lake Shore Dr,
Waco, TX 76708-3718

Ph: (254) 753-0291

Reviews and Comments


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