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NPI Code Detail

MEDICARE: REBECCA RODRIGUEZ PTA

MEDICARE:   REBECCA  RODRIGUEZ  PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant2114487TX

General Provider Information

NPI Number : 1659896926
Entity Type Code : Individual
Provider Name (Legal Business Name) : REBECCA RODRIGUEZ PTA
Provider Business Mailing Address
First Line : 4802 CASTLE ROSE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78218-4133
Country : US
Telephone Number : 210-787-0115
Fax Number :
Provider Business Practice Location Address
First Line : 102 PALO ALTO RD STE 140
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78211-3773
Country : US
Telephone Number : 210-922-1785
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/08/2017
Last Update Date : 08/08/2017

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Directions to “ REBECCA RODRIGUEZ PTA” Practice Location

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